Individual provider Active NPI

Marla Delavallade Hamilton, D.C.

  • Chiropractor
  • Brea, CA
National Provider Identifier
1841335817
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
30456 Issued in CA
Practice address
1211 W Imperial Hwy
Ste 204
Brea, CA 92821-3733
Phone
(562) 347-3587
Fax
(310) 549-6942
NPI assigned
Feb 20, 2007
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30456 CA Primary

Addresses

Primary practice location

1211 W Imperial Hwy
Ste 204
Brea, CA 92821-3733

Mailing address

1211 W Imperial Hwy
Ste 204
Brea, CA 92821-3733
Phone (562) 347-3587

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070515000485 CA Practitioner - Chiropractic 0446357016 Practice locations: Brea, CA; Wilmington, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis W. Shults, DO Inc PastSince Aug 28, 2012 Accepting new patients
Gary Chen MD Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1841335817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W IMPERIAL HWY",
            "address_2": "STE 204",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213733",
            "telephone_number": "562-347-3587",
            "fax_number": "714-671-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W IMPERIAL HWY",
            "address_2": "STE 204",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213733",
            "telephone_number": "562-347-3587",
            "fax_number": "310-549-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MARLA",
        "middle_name": "DELAVALLADE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.