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General NPI Number Information
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NPI Number | 1659601987
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Entity Type | Organization
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Legal Business Name | ILAN HARTSTEIN, MD. INC
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 7851 WALKER ST SUITE 207
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City | LA PALMA
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State | CA
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Zip | 90623-1747
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Country | US
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Telephone | 714-522-4862
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Fax | 714-522-4293
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Provider Business Mailing Address
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Address Line | 7851 WALKER ST SUITE 207
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City | LA PALMA
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State | CA
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Zip | 90623-1747
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Country | US
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Telephone | 714-522-4862
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Fax | 714-522-4293
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Authorized Official
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Title or Position | PRESIDENT, DOCTOR
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Name | MR. ILAN HARTSTEIN
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Credential | M.D.
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Telephone | 714-522-4862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G59917
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License Number State | CA
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