Organization Active NPI

Douglas G Hamilton Medical Corp

  • Dermatopathology Physician
  • Woodland Hills, CA
National Provider Identifier
1093021495
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
G20987 Issued in CA
Legal business name
DOUGLAS G HAMILTON MEDICAL CORP
Practice address
6325 Topanga Canyon Blvd Ste 301
Woodland Hills, CA 91367-2029
Phone
(818) 884-7150
Fax
(818) 884-1254
NPI assigned
Aug 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Douglas G Hamilton, MDNPI 1497815880
Title
President
Phone
(818) 884-7150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0900X G20987 CA Primary

Addresses

Primary practice location

6325 Topanga Canyon Blvd Ste 301
Woodland Hills, CA 91367-2029

Mailing address

12021 Wilshire Blvd # 309
Los Angeles, CA 90025-1206
Phone (818) 884-7150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110624000240 CA Part B Supplier - Clinic/Group Practice 4688852528 Receives reassigned benefits from 2 practitioners
Practice locations: Beverly Hills, CA; Woodland Hills, CA

National Provider Directory

National Provider Directory

Locations

450 N Bedford Dr
Ste 111
Beverly Hills, CA 90210
Phone (310) 271-6663

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1093021495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 WILSHIRE BLVD # 309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251206",
            "telephone_number": "818-884-7150",
            "fax_number": "818-884-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 TOPANGA CANYON BLVD STE 301",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913672029",
            "telephone_number": "818-884-7150",
            "fax_number": "818-884-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS G HAMILTON MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-884-7150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G20987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.