Individual provider Active NPI

Robert Joseph Haag, 702177

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
National Provider Identifier
1265638373
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3779 Issued in CA
Practice address
11429 Miro Cir
San Diego, CA 92131-3316
Phone
(858) 397-2309
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3779 CA Primary

Addresses

Primary practice location

11429 Miro Cir
San Diego, CA 92131-3316

Mailing address

11429 Miro Cir
San Diego, CA 92131-3316
Phone (858) 397-2309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1265638373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11429 MIRO CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313316",
            "telephone_number": "858-397-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11429 MIRO CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313316",
            "telephone_number": "858-397-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "702177",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.