Provider Demographics
NPI:1073390530
Name:HAMILTON FACIAL PLASTIC SURGERY, INC.
Entity Type:Organization
Organization Name:HAMILTON FACIAL PLASTIC SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN & SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-346-8980
Mailing Address - Street 1:4309 RAINTREE CIR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4432
Mailing Address - Country:US
Mailing Address - Phone:310-346-8980
Mailing Address - Fax:
Practice Address - Street 1:6240 W. MANCHESTER AVE. S
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CA
Practice Address - Zip Code:90045
Practice Address - Country:US
Practice Address - Phone:310-657-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty