MEDICARE: MS. ELSA MARIA HARTWICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A065743	CA
2	207RN0300X	Nephrology Physician	A65743	CA

General Provider Information

NPI Number	:	1558375022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELSA MARIA HARTWICK M.D.

Provider Business Mailing Address
First Line	:	2550 W MAIN ST
Second Line	:	SUITE 301
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-1694
Country	:	US
Telephone Number	:	626-457-6900
Fax Number	:	213-743-9001

Provider Business Practice Location Address
First Line	:	1414 S GRAND AVE STE 380
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3072
Country	:	US
Telephone Number	:	213-222-1300
Fax Number	:	213-222-1333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/12/2025

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