Conrad Hamako, MD
Individual provider Active NPI Ophthalmology Physician · Freedom, CA
NPI 1679675029 · NPPES record last updated Jul 24, 2012
Key facts
- NPI
- 1679675029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 00G252850 (CA)
- Practice address
- 160 Green Valley Road
Suite 202
Freedom, CA 95019-3160 - Phone
- (931) 724-1353
- Fax
- (831) 724-9551
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051227000486 | CA | Practitioner - Ophthalmology | 9931121407 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00G252850 | CA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Eye Physicians, a Medical Corporation | Ophthalmology | Current |
Accepting new patients |
| Spectrum Eye Physicians, a Medical Corporation | Ophthalmology | Current |
Accepting new patients |
Locations
10300 S De Anza Blvd
Cupertino, CA 95014
Phone (408) 252-7310
10300 S De Anza Blvd
Ste A
Cupertino, CA 95014
Phone (408) 253-3083
160 Green Valley Rd
Ste 202
Freedom, CA 95019
Phone (408) 252-6985
930 Sunnyslope Rd
Ste E
Hollister, CA 95023
Phone (831) 637-0705
1663 Dominican Way
Ste 212
Santa Cruz, CA 95065
Phone (831) 226-2636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 00G252850 | CA | Yes |
Addresses
Primary practice location
160 Green Valley Road
Suite 202
Freedom, CA 95019-3160
Mailing address
160 Green Valley Road
Suite 202
Freedom, CA 95019-3160
Phone (931) 724-1353
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G252850 | Medicaid | CA |
Other providers in Freedom, CA
- Maria Sembrano Granthom
- Green Valley Laser, LLC
- Gilbert J Grio
- Marc L Grossman
- Vinh Quoc Ha
- Lisa Patrice Hamil
- Terry F. Haskin
- Healthstat on-Site Clinic/Reiter Watsonville
- Healthstat Wellness WG Watsonville
- Rachel Hong
All providers in Freedom, CA · Ophthalmology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.