MEDICARE: MR. FERNANDO H AUSTIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	A30459	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A304590	OTHER	CA	MEDI-CAL #

General Provider Information

NPI Number	:	1174527774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FERNANDO H AUSTIN MD

Provider Business Mailing Address
First Line	:	19066 MAGNOLIA ST.
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646
Country	:	US
Telephone Number	:	714-969-9307
Fax Number	:

Provider Business Practice Location Address
First Line	:	9940 TALBERT AVE
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5153
Country	:	US
Telephone Number	:	714-964-6229
Fax Number	:	714-378-6233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	11/05/2012

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