Provider Demographics
NPI:1164486197
Name:HAMLIN, REGINA C (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:C
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7535 N CHANNING WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-0469
Mailing Address - Country:US
Mailing Address - Phone:559-432-1821
Mailing Address - Fax:559-432-6376
Practice Address - Street 1:7110 N FRESNO ST
Practice Address - Street 2:SUITE 140
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2996
Practice Address - Country:US
Practice Address - Phone:559-432-1821
Practice Address - Fax:559-432-6376
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAO24263174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA23883Medicare UPIN