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General NPI Number Information
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NPI Number | 1164581583
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Entity Type | Individual
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Provider Name | JOHN J HAUPT III M.E.D. CCC-A
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 642 3RD AVE STE G
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City | CHULA VISTA
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State | CA
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Zip | 91910-5733
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Country | US
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Telephone | 619-425-1111
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Fax | 619-498-0846
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Provider Business Mailing Address
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Address Line | PO BOX 95
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City | IMPERIAL BEACH
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State | CA
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Zip | 91933-0095
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Country | US
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Telephone | 619-425-1111
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Fax | 619-498-0846
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AU1261
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License Number State | CA
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