Provider Demographics
NPI:1629010814
Name:AUTIO, LINDSAY A (MD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:A
Last Name:AUTIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25114
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92799-5114
Mailing Address - Country:US
Mailing Address - Phone:714-689-1560
Mailing Address - Fax:
Practice Address - Street 1:400 N MCDOWELL BLVD
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2366
Practice Address - Country:US
Practice Address - Phone:415-898-1228
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46289207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G462890Medicaid
CA00G462890Medicare ID - Type UnspecifiedMEDICARE PPIN
CA00G462890Medicaid