Clifford Thomas Hartman Jr., M.D.
Individual provider Active NPI Allergy Physician · La Canada, CA
NPI 1184772055 · NPPES record last updated Sep 26, 2018
Key facts
- NPI
- 1184772055
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy Physician 207KA0200X
- License
- A25306 (CA)
- Practice address
- 1346 Foothill Blvd., Suite 301
La Canada, CA 91011 - Phone
- (818) 790-1587
- Fax
- (818) 952-3473
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 27, 2016 through Jul 27, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A25306 | CA | MD | Allergy Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | A25306 | CA | Yes |
Addresses
Primary practice location
1346 Foothill Blvd., Suite 301
La Canada, CA 91011
Mailing address
1346 Foothill Blvd., Suite 301
La Canada, CA 91011
Phone (818) 790-1587
Other names
- C. Thomas Hartman Jr.
Other providers in La Canada, CA
- Natascha Kontny Gundersen
- Satish Steve Gupta
- Eli William Hallak
- Farhad Hamidi
- Christine Hanna
- Hillary Lynne Haynes
- Healthylife MG Corp
- Sokunthear Hem
- Christopher John Henry
- Brandon Ho
All providers in La Canada, CA · Allergy Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.