Healthcare Provider Details

I. General information

NPI: 1487987178
Provider Name (Legal Business Name): MINH X BUI, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 VISTA DEL ORO
FULLERTON CA
92831-1331
US

IV. Provider business mailing address

PO BOX 4030
FULLERTON CA
92834-4030
US

V. Phone/Fax

Practice location:
  • Phone: 714-992-4444
  • Fax: 714-879-9999
Mailing address:
  • Phone: 714-992-4444
  • Fax: 714-879-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA51266
License Number StateCA

VIII. Authorized Official

Name: MINH X BUI
Title or Position: PRESIDENT
Credential: MD
Phone: 714-992-4444