Provider Demographics
NPI:1538049598
Name:COLIN HAMBLIN, A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:COLIN HAMBLIN, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:COLIN
Authorized Official - Last Name:HAMBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-663-1082
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:POINT REYES STATION
Mailing Address - State:CA
Mailing Address - Zip Code:94956
Mailing Address - Country:US
Mailing Address - Phone:415-663-1082
Mailing Address - Fax:415-663-9474
Practice Address - Street 1:599 SIR FRANCES DRAKE BLVD
Practice Address - Street 2:SUITE 206A
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904
Practice Address - Country:US
Practice Address - Phone:415-663-1082
Practice Address - Fax:415-663-9474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty