Physician Compare National (NPI:1891893962)

HEALTHCARE PROVIDER: MARIA THERESA PANLILIO SANICOLAS D.P.M.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1891893962
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597765172
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101015000868
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SANICOLAS
	Individual professional last name
Provider First Name	MARIA THERESA
	Individual professional first name
Provider Middle Name	PANLILIO
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	610 S EUCLID AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 304
	Group Practice or individual's line 2 address
City	NATIONAL CITY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	919502953
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050024
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PARADISE VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y