Healthcare Provider Details

I. General information

NPI: 1518076538
Provider Name (Legal Business Name): SUSAN KAY HAMMAR, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 W MAGNOLIA BLVD SUITE 210
BURBANK CA
91506-1753
US

IV. Provider business mailing address

2211 W MAGNOLIA BLVD SUITE 210
BURBANK CA
91506-1753
US

V. Phone/Fax

Practice location:
  • Phone: 818-391-2400
  • Fax: 818-391-2409
Mailing address:
  • Phone: 818-391-2400
  • Fax: 818-391-2409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG53696
License Number StateCA

VIII. Authorized Official

Name: DR. SUSAN KAY HAMMAR
Title or Position: DOCTOR
Credential: MD
Phone: 818-391-2400