Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC21345 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | DC21345 | CA |
NPI | 1023101029 |
---|---|
Provider Name | Dr. Marc C Hamilton |
First Address | San Bernardino, CA 92402-0351 |
Second Address | San Bernardino, CA 92408-3442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 13/04/2010 |