Provider Demographics
NPI:1982844064
Name:HALWEG, GARRETT M (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:M
Last Name:HALWEG
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:PO BOX 1734
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92652-1734
Mailing Address - Country:US
Mailing Address - Phone:949-338-1865
Mailing Address - Fax:
Practice Address - Street 1:2600 E COAST HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2117
Practice Address - Country:US
Practice Address - Phone:949-338-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA732172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry