Provider Demographics
NPI:1477802262
Name:SAMUEL P. AU, MD, INC.
Entity type:Organization
Organization Name:SAMUEL P. AU, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:702-302-7597
Mailing Address - Street 1:7130 N MILLBROOK AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3347
Mailing Address - Country:US
Mailing Address - Phone:559-450-5500
Mailing Address - Fax:559-450-5551
Practice Address - Street 1:7130 N MILLBROOK AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3347
Practice Address - Country:US
Practice Address - Phone:559-450-5500
Practice Address - Fax:559-450-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV134932085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty