Provider Demographics
NPI:1841335817
Name:HAMILTON, MARLA DELAVALLADE (DC)
Entity type:Individual
Prefix:DR
First Name:MARLA
Middle Name:DELAVALLADE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1211 W IMPERIAL HWY
Mailing Address - Street 2:STE 204
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3733
Mailing Address - Country:US
Mailing Address - Phone:562-347-3587
Mailing Address - Fax:714-671-0833
Practice Address - Street 1:1211 W IMPERIAL HWY
Practice Address - Street 2:STE 204
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3733
Practice Address - Country:US
Practice Address - Phone:562-347-3587
Practice Address - Fax:310-549-6942
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor