Provider Demographics
NPI:1740214717
Name:AU, CHAU AI (LAC)
Entity Type:Individual
Prefix:DR
First Name:CHAU
Middle Name:AI
Last Name:AU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 THAINWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1460
Mailing Address - Country:US
Mailing Address - Phone:408-363-8388
Mailing Address - Fax:408-363-8122
Practice Address - Street 1:4070 MONTEREY HWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-3633
Practice Address - Country:US
Practice Address - Phone:408-363-8388
Practice Address - Fax:408-363-8122
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3733171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0037330Medicaid
CAAC3733OtherACUPUNCTURE LICENSE #