Provider Demographics
NPI:1659390227
Name:HAMILTON, MICHELE ANN (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8536 WILSHIRE BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3153
Mailing Address - Country:US
Mailing Address - Phone:310-248-8300
Mailing Address - Fax:310-248-8333
Practice Address - Street 1:8536 WILSHIRE BLVD STE 302
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3153
Practice Address - Country:US
Practice Address - Phone:310-248-8300
Practice Address - Fax:310-248-8333
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57890207R00000X, 207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G578900OtherMEDICAL PPIN #
CA00G578900OtherMEDICAL PPIN #