Provider Demographics
NPI:1609061324
Name:DENNIS L. HAMBY, MD
Entity Type:Organization
Organization Name:DENNIS L. HAMBY, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-997-0555
Mailing Address - Street 1:1500 SOUTHGATE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2231
Mailing Address - Country:US
Mailing Address - Phone:650-997-0555
Mailing Address - Fax:
Practice Address - Street 1:1500 SOUTHGATE AVE
Practice Address - Street 2:201
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2259
Practice Address - Country:US
Practice Address - Phone:650-997-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:490 POST STREET, SUITE 939 SAN FRANCISCO, CA94109
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C268331Medicare PIN
CA00C268330Medicare PIN
CAA33226Medicare UPIN