Healthcare Provider Details

I. General information

NPI: 1134261134
Provider Name (Legal Business Name): KEVIN HAUG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 STOCKTON BLVD
SACRAMENTO CA
95817-2208
US

IV. Provider business mailing address

230 SAN MIGUEL WAY
SACRAMENTO CA
95819-1932
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2131
  • Fax:
Mailing address:
  • Phone: 916-440-6650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberA81885
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA81885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: