Healthcare Provider Details

I. General information

NPI: 1275829608
Provider Name (Legal Business Name): FRANCIS JOSEPH HARTGE IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR
SAN DIEGO CA
92134-0001
US

IV. Provider business mailing address

924 F AVE
CORONADO CA
92118-2510
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7400
  • Fax:
Mailing address:
  • Phone: 614-783-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101252684
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101252684
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: