Individual provider Active NPI

Kambiz Hamrang, M.D.

  • Gynecology Physician
  • San Diego, CA
National Provider Identifier
1215066881
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
A42928 Issued in AR
Practice address
3490 Palm Ave
San Diego, CA 92154-1664
Phone
(858) 429-1800
Fax
(858) 459-0045
NPI assigned
Mar 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X A42928 AR Primary

Addresses

Primary practice location

3490 Palm Ave
San Diego, CA 92154-1664

Mailing address

PO Box 1800
La Jolla, CA 92038-1800
Phone (858) 459-1800

Other identifiers 1

IdentifierTypeStateIssuer
00A429281MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A42928ARMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215066881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1800",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920381800",
            "telephone_number": "858-459-1800",
            "fax_number": "858-459-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541664",
            "telephone_number": "858-429-1800",
            "fax_number": "858-459-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMRANG",
        "first_name": "KAMBIZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AR",
            "license": "A42928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A429281",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.