Provider Demographics
NPI:1710058532
Name:KAU, ERIC LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LEE
Last Name:KAU
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 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-865-3700
Mailing Address - Fax:
Practice Address - Street 1:125 W HUNTINGTON DR BLDG B
Practice Address - Street 2:SUITE B200
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3050
Practice Address - Country:US
Practice Address - Phone:626-281-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89398174400000X, 208600000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI35585Medicare UPIN