Healthcare Provider Details

I. General information

NPI: 1134164940
Provider Name (Legal Business Name): MEREDITH ANDREA HAMEL MA, ATC, MT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 PALMS BLVD
LOS ANGELES CA
90066-2104
US

IV. Provider business mailing address

11350 PALMS BLVD
LOS ANGELES CA
90066-2104
US

V. Phone/Fax

Practice location:
  • Phone: 310-391-7127
  • Fax: 310-391-1376
Mailing address:
  • Phone: 310-391-7127
  • Fax: 310-391-1376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: