Provider Demographics
NPI:1174881536
Name:SCOTT AU, MD, INC
Entity type:Organization
Organization Name:SCOTT AU, MD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-773-7000
Mailing Address - Street 1:1950 SUNNYCREST DR
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3638
Mailing Address - Country:US
Mailing Address - Phone:714-773-7000
Mailing Address - Fax:714-870-5028
Practice Address - Street 1:1950 SUNNYCREST DR
Practice Address - Street 2:SUITE 2000
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3638
Practice Address - Country:US
Practice Address - Phone:714-773-7000
Practice Address - Fax:714-870-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108075208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA108075OtherSTATE LICENSE