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General NPI Number Information
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NPI Number | 1538346911
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Entity Type | Individual
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Provider Name | MICHAEL SHANE HAMMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 9339 GENESEE AVE STE 350
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City | SAN DIEGO
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State | CA
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Zip | 92121-2150
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Country | US
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Telephone | 858-454-4300
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Fax | 858-454-5088
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Provider Business Mailing Address
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Address Line | 12700 PARK CENTRAL DR STE 1210
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City | DALLAS
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State | TX
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Zip | 75251-1522
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Country | US
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Telephone | 702-360-2763
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Fax | 949-783-2880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A97551
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A97551
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | A97551
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License Number State | CA
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