Healthcare Provider Details
I. General information
NPI: 1417335001
Provider Name (Legal Business Name): SHAWN H. HAMILTON, M.D.,INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2015
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4902 IRVINE CENTER DR STE 105
IRVINE CA
92604-3334
US
IV. Provider business mailing address
304 S JONES BLVD STE 2404
LAS VEGAS NV
89107-2623
US
V. Phone/Fax
- Phone: 949-651-9671
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385HR2050X |
| Taxonomy | Respite Care Camp |
| License Number | NP95001413 |
| License Number State | CA |
VIII. Authorized Official
Name:
SHAWN
HAMILTON
Title or Position: MD
Credential:
Phone: 702-997-6651