Provider Demographics
NPI:1750598025
Name:HARTAS, GEORGIOS A (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGIOS
Middle Name:A
Last Name:HARTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N CENTRAL AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2061
Mailing Address - Country:US
Mailing Address - Phone:818-839-7101
Mailing Address - Fax:818-839-7199
Practice Address - Street 1:411 N CENTRAL AVE STE 250
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2061
Practice Address - Country:US
Practice Address - Phone:818-839-7101
Practice Address - Fax:818-839-7199
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1459862080P0202X
VA0101238900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty