Provider Demographics
NPI:1235280793
Name:ALLAN R AU MD INC
Entity Type:Organization
Organization Name:ALLAN R AU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:916-686-8170
Mailing Address - Street 1:9727 ELK GROVE FLORIN RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2264
Mailing Address - Country:US
Mailing Address - Phone:916-686-8170
Mailing Address - Fax:916-685-8195
Practice Address - Street 1:9727 ELK GROVE FLORIN RD
Practice Address - Street 2:SUITE 180
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2264
Practice Address - Country:US
Practice Address - Phone:916-686-8170
Practice Address - Fax:916-685-8195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76867207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF65885Medicare UPIN
CAZZZ04152ZMedicare PIN