Basic Information
Provider Information
NPI: 1477526978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMILTON
FirstName: REBECA
MiddleName: G.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 780 KUENZLI ST
Address2: SUITE 202
City: RENO
State: NV
PostalCode: 895021011
CountryCode: US
TelephoneNumber: 7759824590
FaxNumber: 7759824595
Practice Location
Address1: 77 PRINGLE WAY
Address2:  
City: RENO
State: NV
PostalCode: 895021474
CountryCode: US
TelephoneNumber: 7759827878
FaxNumber: 7759824196
Other Information
ProviderEnumerationDate: 02/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X7483NVY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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