Healthcare Provider Details

I. General information

NPI: 1790785699
Provider Name (Legal Business Name): JUDITH B HARTMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 YGNACIO VALLEY RD BLDG. E, SUITE 101
WALNUT CREEK CA
94598-3383
US

IV. Provider business mailing address

2121 YGNACIO VALLEY RD BLDG. E, SUITE 101
WALNUT CREEK CA
94598-3383
US

V. Phone/Fax

Practice location:
  • Phone: 925-945-6600
  • Fax: 925-945-7842
Mailing address:
  • Phone: 925-945-6600
  • Fax: 925-945-7842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG38913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: