Provider Demographics
NPI:1114240157
Name:HAMILTON, ROBIN MB
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MB
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 HUGHES AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2751
Mailing Address - Country:US
Mailing Address - Phone:310-837-9700
Mailing Address - Fax:310-837-9701
Practice Address - Street 1:3831 HUGHES AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2751
Practice Address - Country:US
Practice Address - Phone:310-837-9700
Practice Address - Fax:310-837-9701
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36367225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist