Provider Demographics
NPI:1508053141
Name:HAMADA, JAMES SADAO (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:SADAO
Last Name:HAMADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21500 PIONEER BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-2600
Mailing Address - Country:US
Mailing Address - Phone:310-543-1391
Mailing Address - Fax:310-540-2344
Practice Address - Street 1:21500 PIONEER BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-2600
Practice Address - Country:US
Practice Address - Phone:310-543-1391
Practice Address - Fax:310-540-2344
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30470207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W14084OtherMEDICARE GROUP PROVIDER N
CA00C304700Medicaid
W14084AOtherMEDICARE GROUP PROVIDER N
CAA34275Medicare UPIN
CAWC30470FMedicare PIN
W14084AOtherMEDICARE GROUP PROVIDER N