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General NPI Number Information
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NPI Number | 1912314303
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Entity Type | Organization
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Legal Business Name | TRI CITY ORTHOPAEDIC SURGERY MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1958 VIA CENTRE DR
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City | VISTA
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State | CA
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Zip | 92081-6056
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Country | US
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Telephone | 760-724-9000
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Fax | 760-724-3686
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Provider Business Mailing Address
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Address Line | 3905 WARING RD
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City | OCEANSIDE
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State | CA
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Zip | 92056-4405
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Country | US
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Telephone | 760-724-9000
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Fax | 760-724-3686
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW HARTMAN
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Credential | M.D.
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Telephone | 760-724-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251H1200X
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Taxonomy Name | Hand Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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