Provider Demographics
NPI:1508392572
Name:AU, BRIAN (DPM)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:AU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2111
Mailing Address - Country:US
Mailing Address - Phone:714-771-4191
Mailing Address - Fax:714-771-2731
Practice Address - Street 1:1038 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2111
Practice Address - Country:US
Practice Address - Phone:714-771-4191
Practice Address - Fax:714-771-2731
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5633213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist