Healthcare Provider Details

I. General information

NPI: 1104852292
Provider Name (Legal Business Name): NATHAN C HAMAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44439 17TH ST W # 210
LANCASTER CA
93534-2831
US

IV. Provider business mailing address

44439 17TH ST W # 210
LANCASTER CA
93534-2831
US

V. Phone/Fax

Practice location:
  • Phone: 816-838-3464
  • Fax: 818-672-2700
Mailing address:
  • Phone: 816-838-3464
  • Fax: 818-672-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC205778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: