Provider Demographics
NPI:1821167206
Name:HAUGH, SEAN YOUNG-IL (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:YOUNG-IL
Last Name:HAUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 THE ALAMEDA
Mailing Address - Street 2:STE 228
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2305
Mailing Address - Country:US
Mailing Address - Phone:408-293-3971
Mailing Address - Fax:408-293-1029
Practice Address - Street 1:1570 THE ALAMEDA
Practice Address - Street 2:STE 228
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2305
Practice Address - Country:US
Practice Address - Phone:408-293-3971
Practice Address - Fax:408-293-1029
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA651072084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABY202WMedicare PIN