Provider Demographics
NPI:1982710810
Name:HAMBURGER, JEROME A (MD)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:A
Last Name:HAMBURGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16133 VENTURA BLVD
Mailing Address - Street 2:SUITE 1180
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2403
Mailing Address - Country:US
Mailing Address - Phone:818-990-5665
Mailing Address - Fax:818-905-5426
Practice Address - Street 1:16133 VENTURA BLVD
Practice Address - Street 2:SUITE 1180
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2403
Practice Address - Country:US
Practice Address - Phone:818-990-5665
Practice Address - Fax:818-905-5426
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG12245207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease