Basic Information
Provider Information
NPI: 1144478306
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AU
FirstName: KAREN
MiddleName: MAE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 VETERAN AVE
Address2: REHAB BLDG 32-59
City: LOS ANGELES
State: CA
PostalCode: 900242704
CountryCode: US
TelephoneNumber: 3108252448
FaxNumber: 3107946553
Practice Location
Address1: 1000 VETERAN AVE
Address2: REHAB BLDG 32-59
City: LOS ANGELES
State: CA
PostalCode: 900242704
CountryCode: US
TelephoneNumber: 3108252448
FaxNumber: 3107946553
Other Information
ProviderEnumerationDate: 08/29/2008
LastUpdateDate: 12/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XA100616CAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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