Healthcare Provider Details

I. General information

NPI: 1609975408
Provider Name (Legal Business Name): TUNG BUU D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13151 BROOKHURST ST
GARDEN GROVE CA
92843-1079
US

IV. Provider business mailing address

13151 BROOKHURST ST
GARDEN GROVE CA
92843-1079
US

V. Phone/Fax

Practice location:
  • Phone: 714-539-1300
  • Fax:
Mailing address:
  • Phone: 714-539-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-26683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: