Provider Demographics
NPI:1235562687
Name:AUR, RADIN (DPM)
Entity Type:Individual
Prefix:
First Name:RADIN
Middle Name:
Last Name:AUR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 GRAND CANAL BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-8110
Mailing Address - Country:US
Mailing Address - Phone:209-952-1612
Mailing Address - Fax:209-952-1631
Practice Address - Street 1:1810 GRAND CANAL BLVD STE 2
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-8110
Practice Address - Country:US
Practice Address - Phone:209-952-1612
Practice Address - Fax:209-952-1631
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5265213ES0103X
PASC006522213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery