Ann Ewalt Hamilton MD Medical Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G22428 Issued in CA

Legal business name

ANN EWALT HAMILTON MD MEDICAL CORP

Practice address

4294 Orange St
Riverside, CA 92501-3827

Phone

(951) 788-0210

Fax

(951) 788-6330

NPI assigned

Sep 13, 2005

Last updated

Dec 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ann Ewalt Hamilton, MD

Title

Director Ceo

Phone

(951) 788-0210

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1700871001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4294 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013827",
            "telephone_number": "951-788-0210",
            "fax_number": "951-788-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4294 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013827",
            "telephone_number": "951-788-0210",
            "fax_number": "951-788-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN EWALT HAMILTON MD MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "EWALT",
        "authorized_official_title_or_position": "DIRECTOR CEO",
        "authorized_official_telephone_number": "951-788-0210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G22428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G224280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.

Verify at the official NPI Registry.