Basic Information
| Provider Information | |||||||||
| NPI: | 1659590974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMILTON | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4150 V ST STE 3500 | ||||||||
| Address2: | GASTROENTEROLOGY DIVISION | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347224 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4150 V ST STE 3500 | ||||||||
| Address2: | GASTROENTEROLOGY DIVISION | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347224 | ||||||||
| FaxNumber: | 9167347908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2007 | ||||||||
| LastUpdateDate: | 11/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | NPF16236 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 116780 | 01 | SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER | OTHER |