Provider Demographics
NPI:1407588858
Name:AU, NICHOLAS THONG (MSN, APRN, AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:THONG
Last Name:AU
Suffix:
Gender:M
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2116
Mailing Address - Country:US
Mailing Address - Phone:626-915-4700
Mailing Address - Fax:626-214-7814
Practice Address - Street 1:235 E BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2116
Practice Address - Country:US
Practice Address - Phone:626-915-4700
Practice Address - Fax:626-214-7814
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95275145163WC0200X
CA95036173363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine