Individual
MR. PERRY ALLAN HAUGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
940 SYLVA LN STE G, SONORA, CA 95370-5969
(209) 532-0340
(209) 532-6405
Mailing address
940 SYLVA LN STE G, SONORA, CA 95370-5969
(209) 532-0340
(209) 532-6405
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G85829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G858290
—
CA
05
—
00G858291
—
CA
01
—
1299310002
SECOND DEMERC PIN
CA
01
—
180040947
RAILROAD MEDICARE PIN
CA
Enumeration date
02/23/2007
Last updated
04/29/2015
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