Healthcare Provider Details

I. General information

NPI: 1083302939
Provider Name (Legal Business Name): COLLEEN HAMILTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1845 WHITE OAK DR
MENLO PARK CA
94025-6130
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2345
  • Fax:
Mailing address:
  • Phone: 650-387-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA209906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: