Healthcare Provider Details

I. General information

NPI: 1932253960
Provider Name (Legal Business Name): HANA T. BUI, MD, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 N HARBOR BLVD STE 101
FULLERTON CA
92835-4129
US

IV. Provider business mailing address

1321 N HARBOR BLVD STE 101
FULLERTON CA
92835-4129
US

V. Phone/Fax

Practice location:
  • Phone: 714-870-4822
  • Fax: 714-870-4804
Mailing address:
  • Phone: 714-870-4822
  • Fax: 714-870-4804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberG064344
License Number StateCA

VIII. Authorized Official

Name: DR. HANA T. BUI
Title or Position: PRESIDENT
Credential: MD
Phone: 714-870-4822