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Physician Compare National (NPI:1902916711)

HEALTHCARE PROVIDER: KHALED ALY TAWANSY M.D.

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

Individual Professional Information

NPI 1902916711
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5698795664
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20051206000327
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name TAWANSY
Individual professional last name
Provider First Name KHALED
Individual professional first name
Provider Middle Name A
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Individual professional's medical school
Graduation Year 1991
Individual professional's medical school graduation year
Primary Specialty OPHTHALMOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name PAUL P NAZEMI MD INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 8729159173
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 199 W HILLCREST DR
Group Practice or individual's line 1 address
City THOUSAND OAKS
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 913607892
Group Practice or individual's zip code (9 digits when available)
Phone Number 8054977976
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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