MEDICARE: DR. BLANCA HAMPTON M.D.

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	208000000X	Pediatrics Physician	A45098	CA

General Provider Information

NPI Number	:	1245263953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLANCA HAMPTON M.D.

Provider Business Mailing Address
First Line	:	1110 W LA PALMA AVE
Second Line	:	SUITE 1
City	:	ANAHEIM
State	:	CA
Zip	:	92801-2821
Country	:	US
Telephone Number	:	714-991-3180
Fax Number	:	714-991-1957

Provider Business Practice Location Address
First Line	:	1110 W LA PALMA AVE
Second Line	:	SUITE 1
City	:	ANAHEIM
State	:	CA
Zip	:	92801-2821
Country	:	US
Telephone Number	:	714-991-3180
Fax Number	:	714-991-1957

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

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	02/28/2013

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