MEDICARE: ROBERT LESTER HAMPTON III 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	2084P0800X	Psychiatry Physician	G47617	CA

General Provider Information

NPI Number	:	1922271709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LESTER HAMPTON III M.D.

Provider Business Mailing Address
First Line	:	7212 ORANGETHORPE AVE
Second Line	:	SUITE 9 A
City	:	BUENA PARK
State	:	CA
Zip	:	90621-3341
Country	:	US
Telephone Number	:	714-449-1125
Fax Number	:	714-562-8729

Provider Business Practice Location Address
First Line	:	615 W BAY AVE
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92661-1157
Country	:	US
Telephone Number	:	949-500-6231
Fax Number	:	949-675-2569

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

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	01/05/2012

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