Provider Demographics
NPI:1790097970
Name:AU, SANDRA P (DPM)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:P
Last Name:AU
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:407 ULUNIU ST
Mailing Address - Street 2:# 107
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:407 ULUNIU ST
Practice Address - Street 2:STE 107
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2530
Practice Address - Country:US
Practice Address - Phone:808-266-0066
Practice Address - Fax:808-263-6004
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI200213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery