Provider Demographics
NPI:1205399052
Name:HAMBRO, BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:HAMBRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ROWLAND WAY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3306
Mailing Address - Country:US
Mailing Address - Phone:415-897-5171
Mailing Address - Fax:415-892-1611
Practice Address - Street 1:75 ROWLAND WAY
Practice Address - Street 2:SUITE 230
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3306
Practice Address - Country:US
Practice Address - Phone:415-897-5171
Practice Address - Fax:415-892-1611
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA179951207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine