1053387563 NPI number — DR. ROBERT J HAMBURG MD

Table of content: DR. ROBERT J HAMBURG MD (NPI 1053387563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053387563 NPI number — DR. ROBERT J HAMBURG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMBURG
Provider First Name:
ROBERT
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053387563
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 NORTH DOBSON ROAD
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85224-4412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-899-2020
Provider Business Mailing Address Fax Number:
480-899-9081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 NORTH DOBSON ROAD
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224-4412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-899-2020
Provider Business Practice Location Address Fax Number:
480-899-9081
Provider Enumeration Date:
02/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  21505 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 21505 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 141622 . This is a "STATE AHCCCS NUMBER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 141622001 . This is a "AHCCCS MERCYCARE NUMBER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 531914 . This is a "AHCCCS MEDICARE CROSSOVER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0863170 . This is a "BC/BS OF ARIZONA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 060067938 . This is a "RAILROAD MEDICARE NUMBER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 20451 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 337562 . This is a "ONE HEALTH PLAN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 95964 . This is a "PACIFICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 2Z0239 . This is a "HEALTHNET OF ARIZONA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 3297847021 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860957700 . This is a "HUMANA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 2207187 . This is a "AZ PHYSICIANS IPA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 100143 . This is a "HEALTHCARE COMPARE AFFORD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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