MEDICARE: DR. MARC C HAMILTON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor	DC21345	CA
2	111N00000X	Chiropractor	DC21345	CA

General Provider Information

NPI Number	:	1023101029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC C HAMILTON DC

Provider Business Mailing Address
First Line	:	P.O. BOX 351
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92402-0351
Country	:	US
Telephone Number	:	909-890-1888
Fax Number	:	909-890-0196

Provider Business Practice Location Address
First Line	:	1881 COMMERCENTER EAST
Second Line	:	SUITE 112
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-3442
Country	:	US
Telephone Number	:	909-890-1888
Fax Number	:	909-890-0196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	04/13/2010

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