Provider Demographics
NPI:1538128129
Name:HAUG, DEBORAH S (OD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:S
Last Name:HAUG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3842
Mailing Address - Country:US
Mailing Address - Phone:760-753-3500
Mailing Address - Fax:760-753-3491
Practice Address - Street 1:893 SANTA FE DR
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3842
Practice Address - Country:US
Practice Address - Phone:760-753-3500
Practice Address - Fax:760-753-3491
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10201TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2794OtherMEDICAL EYE SERVICES
CAU53989Medicare UPIN