Provider Demographics
NPI:1124233820
Name:HAMER, MERLIN J (MD)
Entity type:Individual
Prefix:DR
First Name:MERLIN
Middle Name:J
Last Name:HAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-554-7989
Mailing Address - Fax:
Practice Address - Street 1:10666 N. TORREY PINES RD.
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-554-7989
Practice Address - Fax:858-554-6321
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105394207X00000X, 207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200869890Medicaid
IN01063128AOtherLICENSE
IN000000530888OtherANTHEM
IN01063128AOtherLICENSE
IN000000530888OtherANTHEM