Individual
DR. LOUIE HAIDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12649 POWAY RD, POWAY, CA 92064-4415
(858) 486-6100
(858) 486-4564
Mailing address
8076 DICENZA LN, SAN DIEGO, CA 92119-1124
(858) 335-9390
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
51780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D51780
—
CA
Enumeration date
03/19/2007
Last updated
12/07/2017
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