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Organization

ANN EWALT HAMILTON MD MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANN EWALT HAMILTON MD (DIRECTOR CEO)
(951) 788-0210
Entity
Organization

Contact information

Practice address
4294 ORANGE ST, RIVERSIDE, CA 92501-3827
(951) 788-0210
(951) 788-6330
Mailing address
4294 ORANGE ST, RIVERSIDE, CA 92501-3827
(951) 788-0210
(951) 788-6330

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G22428
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G224280
CA
Enumeration date
09/13/2005
Last updated
12/28/2012
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