Provider Demographics
NPI:1720430739
Name:DAVID J. HAUPT, DPM
Entity Type:Organization
Organization Name:DAVID J. HAUPT, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:HAUPT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:949-706-3838
Mailing Address - Street 1:373 MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-1460
Mailing Address - Country:US
Mailing Address - Phone:949-706-3838
Mailing Address - Fax:949-706-9726
Practice Address - Street 1:400 NEWPORT CENTER DR
Practice Address - Street 2:SUITE #411
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7601
Practice Address - Country:US
Practice Address - Phone:949-706-3838
Practice Address - Fax:949-706-9726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier