Provider Demographics
NPI:1306835723
Name:HAMSTRA, WILLIAM NORMAN (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:NORMAN
Last Name:HAMSTRA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2305 CAMINO RAMON
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1396
Mailing Address - Country:US
Mailing Address - Phone:925-447-0660
Mailing Address - Fax:925-443-7506
Practice Address - Street 1:2305 CAMINO RAMON
Practice Address - Street 2:SUITE 217
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1396
Practice Address - Country:US
Practice Address - Phone:925-447-0660
Practice Address - Fax:925-443-7506
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5413208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX54131Medicaid
CA00AX54131Medicaid
F08746Medicare UPIN