Physician Compare National (NPI:1912990656)

HEALTHCARE PROVIDER: JACK HUGH FLORIN MD

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

Individual Professional Information
NPI	1912990656
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052300605
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120125000646
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FLORIN
	Individual professional last name
Provider First Name	JACK
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	100 LAGUNA RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 208
	Group Practice or individual's line 2 address
City	FULLERTON
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	928353633
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050168
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JUDE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050589
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PLACENTIA LINDA HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y