Provider Demographics
NPI:1962172692
Name:HAMILTON, EVAN M (DC)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 HARBOR CLIFF WAY UNIT 247
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2276
Mailing Address - Country:US
Mailing Address - Phone:619-323-5020
Mailing Address - Fax:
Practice Address - Street 1:2623 GATEWAY RD STE 104
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-1751
Practice Address - Country:US
Practice Address - Phone:760-931-8003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor