Healthcare Provider Details

I. General information

NPI: 1528362126
Provider Name (Legal Business Name): BUJA ENTERPRISE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2010
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 ORANGE AVE
CYPRESS CA
90630-2715
US

IV. Provider business mailing address

4021 ORANGE AVE
CYPRESS CA
90630-2715
US

V. Phone/Fax

Practice location:
  • Phone: 562-283-8223
  • Fax: 888-440-4843
Mailing address:
  • Phone: 562-283-8223
  • Fax: 888-440-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LEE
Title or Position: DIRECTOR
Credential:
Phone: 562-283-8223