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General NPI Number Information
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NPI Number | 1750598025
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Entity Type | Individual
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Provider Name | GEORGIOS A. HARTAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 411 N CENTRAL AVE STE 250
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City | GLENDALE
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State | CA
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Zip | 91203-2061
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Country | US
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Telephone | 818-839-7101
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Fax | 818-839-7199
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Provider Business Mailing Address
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Address Line | 411 N CENTRAL AVE STE 250
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City | GLENDALE
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State | CA
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Zip | 91203-2061
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Country | US
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Telephone | 818-839-7101
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Fax | 818-839-7199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 145986
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License Number State | CA
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