Provider Demographics
NPI:1740588029
Name:HAMMAN, CHRIS LEE
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:LEE
Last Name:HAMMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 POLLOCK AVE.
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:CA
Mailing Address - Zip Code:95623
Mailing Address - Country:US
Mailing Address - Phone:530-626-3684
Mailing Address - Fax:
Practice Address - Street 1:6308 POLLOCK AVE.
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:CA
Practice Address - Zip Code:95623
Practice Address - Country:US
Practice Address - Phone:530-626-3684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11032174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11032OtherCAS