Provider Demographics
NPI:1578718243
Name:AUWINGER, BRAD HENRY (DO)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:HENRY
Last Name:AUWINGER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 010 BASEMENT
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:5765 GREENBACK LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-2013
Practice Address - Country:US
Practice Address - Phone:916-865-1040
Practice Address - Fax:916-865-1045
Is Sole Proprietor?:No
Enumeration Date:2008-11-23
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A10620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADO839ZMedicare PIN