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ProviderCode | Provider Name | Physician ID | Last Name | First Name | Middle Name | TIN # | Specialization | Sub Specialization |
|---|---|---|---|---|---|---|---|---|
'002670 | PMP PAIN CENTER CORPORATION- ROSALES BRANCH | '005700 | SO | ANTHONY | CHAN | 206538565000 | Physical Medicine & Rehabilitation (PM&R) | |
'002670 | PMP PAIN CENTER CORPORATION- ROSALES BRANCH | '033254 | LAMOG | FERDINAND | ..01452 | Orthopedic Surgery | ||
'002670 | PMP PAIN CENTER CORPORATION- ROSALES BRANCH | '033967 | MANAOIS | RALPH AUGUST | SALCEDO | 71324227400000 | Orthopedic Surgery |
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