Basic Information
| Provider Information | |||||||||
| NPI: | 1124256235 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUDON | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11037 WARNER AVE | ||||||||
| Address2: | SUITE 216 | ||||||||
| City: | FOUNTAIN VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927084007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142852385 | ||||||||
| FaxNumber: | 8188311808 | ||||||||
| Practice Location | |||||||||
| Address1: | 10900 WARNER AVE | ||||||||
| Address2: | SUITE 101A | ||||||||
| City: | FOUNTAIN VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927083846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142852385 | ||||||||
| FaxNumber: | 8188311808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2009 | ||||||||
| LastUpdateDate: | 06/29/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | G80821 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.