Healthcare Provider Details

I. General information

NPI: 1205886629
Provider Name (Legal Business Name): ERA ELIZABETH HAMILTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/29/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 AVOCADO AVE SUITE 100
NEWPORT BEACH CA
92660-7798
US

IV. Provider business mailing address

1601 AVOCADO AVE SUITE 100
NEWPORT BEACH CA
92660-7798
US

V. Phone/Fax

Practice location:
  • Phone: 949-719-3600
  • Fax:
Mailing address:
  • Phone: 949-719-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA74708
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: