Provider Demographics
NPI:1548410079
Name:HAMADA, MICHAEL OSAMU (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:OSAMU
Last Name:HAMADA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 7TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2629
Mailing Address - Country:US
Mailing Address - Phone:310-394-8807
Mailing Address - Fax:310-458-8804
Practice Address - Street 1:1460 7TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2629
Practice Address - Country:US
Practice Address - Phone:310-394-8807
Practice Address - Fax:310-458-8804
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-20
Last Update Date:2008-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305551223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics