Active NPI
Nicolas David Hamelin, MD
- Plastic Surgery Physician
- Los Angeles, CA
National Provider Identifier
1689945073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- A121553
- Practice address
- 1510 San Pablo Street
Los Angeles, CA 90033-5320 - Phone
- (323) 442-7903
- Fax
- (323) 442-6020
- NPI assigned
- Jan 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | R12717 | ZZ | |
| Plastic Surgery Physician | 208200000X | A121553 | CA | Primary |
Addresses
Primary practice location
1510 San Pablo Street
Los Angeles, CA 90033-5320
Mailing address
205 Montarville
Longueuil, QUEBEC J4H 2L6
CA
Phone (514) 279-0749
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689945073 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R12717 | ZZ | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352764800000",
"number": "1689945073",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "205 MONTARVILLE",
"city": "LONGUEUIL",
"state": "QUEBEC",
"postal_code": "J4H 2L6",
"telephone_number": "514-279-0749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 SAN PABLO STREET",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335320",
"telephone_number": "323-442-7903",
"fax_number": "323-442-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMELIN",
"first_name": "NICOLAS",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-18",
"last_updated": "2012-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "ZZ",
"license": "R12717",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "A121553",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689945073",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.