Healthcare Provider Details

I. General information

NPI: 1801880729
Provider Name (Legal Business Name): STERLING J HAIDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 HOSPITAL DR STE 200, ORCHARD PAVILION
MOUNTAIN VIEW CA
94040-4101
US

IV. Provider business mailing address

2485 HOSPITAL DR STE 200, ORCHARD PAVILION
MOUNTAIN VIEW CA
94040-4101
US

V. Phone/Fax

Practice location:
  • Phone: 650-988-7480
  • Fax: 650-988-7482
Mailing address:
  • Phone: 650-988-7480
  • Fax: 650-988-7482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG240870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: