Provider Demographics
NPI:1275544942
Name:HARTMAN, JEFFREY L (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128
Mailing Address - Country:US
Mailing Address - Phone:408-244-6118
Mailing Address - Fax:408-244-9733
Practice Address - Street 1:325 S MONROE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-244-6118
Practice Address - Fax:408-244-9733
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0219970Medicare ID - Type Unspecified
CAU50475Medicare UPIN