Healthcare Provider Details

I. General information

NPI: 1619809191
Provider Name (Legal Business Name): MICHAEL JOSEPH HAMER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17011 BEACH BLVD STE 900
HUNTINGTON BEACH CA
92647-5998
US

IV. Provider business mailing address

16801 DALE VISTA LN
HUNTINGTON BEACH CA
92647-4363
US

V. Phone/Fax

Practice location:
  • Phone: 714-602-4820
  • Fax:
Mailing address:
  • Phone: 714-654-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: