Provider Demographics
NPI:1588839393
Name:HAMM, JOE BRET (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:BRET
Last Name:HAMM
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:28534 TRISTANT RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2173
Mailing Address - Country:US
Mailing Address - Phone:619-770-8046
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-524-9356
Practice Address - Fax:619-524-9207
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX13548363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN