Provider Demographics
NPI:1851766315
Name:HARTWIG, ELIZABETH MAGLUYAN (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAGLUYAN
Last Name:HARTWIG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23406 VIA RONDA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2233
Mailing Address - Country:US
Mailing Address - Phone:949-274-5922
Mailing Address - Fax:
Practice Address - Street 1:801 N TUSTIN AVE STE 507
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3609
Practice Address - Country:US
Practice Address - Phone:949-566-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA66915363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant