Provider Demographics
NPI:1538218136
Name:HAMPTON, MICHAEL SEAN (MPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SEAN
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10635 SANTA MONICA BLVD STE 165
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-8306
Mailing Address - Country:US
Mailing Address - Phone:310-481-0644
Mailing Address - Fax:310-474-4034
Practice Address - Street 1:10635 SANTA MONICA BLVD STE 165
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8306
Practice Address - Country:US
Practice Address - Phone:310-481-0644
Practice Address - Fax:310-474-4034
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19916225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT19916BMedicare ID - Type Unspecified
CAS76380Medicare UPIN
CAWPT19916AMedicare ID - Type Unspecified