MEDICARE: RENEE HAAS CNP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	278747	CA

General Provider Information

NPI Number	:	1588873608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE HAAS CNP

Provider Business Mailing Address
First Line	:	3998 VISTA WAY STE C202
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-4518
Country	:	US
Telephone Number	:	760-758-1220
Fax Number	:	760-758-9735

Provider Business Practice Location Address
First Line	:	3998 VISTA WAY STE C202
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-4518
Country	:	US
Telephone Number	:	760-758-1220
Fax Number	:	760-758-9735

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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