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ProviderCode | Provider Name | Physician ID | Last Name | First Name | Middle Name | TIN # | Specialization | Sub Specialization |
|---|---|---|---|---|---|---|---|---|
'001716 | IDOC AMBULATORY EYE CARE CLINIC | '021857 | WONG | ALLAN KENNETH | YOUNG | 250526175 | Ophthalmology | |
'001716 | IDOC AMBULATORY EYE CARE CLINIC | '030007 | DIAZ | MARK FERNAN | ANTONIO | 433805712 | ||
'001716 | IDOC AMBULATORY EYE CARE CLINIC | '027866 | FERNANDEZ | MICHAEL | FRANCO | 461107852 | Ophthalmology | |
'001716 | IDOC AMBULATORY EYE CARE CLINIC | '001073 | VALENCIA | NICCOLO ZANDRO | RIGOR | 296768578000 | Ophthalmology | |
'001716 | IDOC AMBULATORY EYE CARE CLINIC | '007449 | ARAYATA | PHILIP CESAR | 215921643001 | Ophthalmology | ||
'001716 | IDOC AMBULATORY EYE CARE CLINIC | '001045 | BONIOL | RAMON AUGUSTUS | D. | 208217393 | Ophthalmology |
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