Healthcare Provider Details

I. General information

NPI: 1225323785
Provider Name (Legal Business Name): TONY BUI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20950 N TATUM BLVD STE 100
PHOENIX AZ
85050-4204
US

IV. Provider business mailing address

20950 N TATUM BLVD STE 100
PHOENIX AZ
85050-4204
US

V. Phone/Fax

Practice location:
  • Phone: 480-222-7246
  • Fax: 480-222-7271
Mailing address:
  • Phone: 480-222-7246
  • Fax: 480-222-7271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number50572
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberD01889748
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: