Healthcare Provider Details

I. General information

NPI: 1215087093
Provider Name (Legal Business Name): TRINH NGOC BUI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10402 WESTMINSTER AVE SUITE 100 C
GARDEN GROVE CA
92843-4861
US

IV. Provider business mailing address

4925 VIA DEL CERRO
YORBA LINDA CA
92887-2644
US

V. Phone/Fax

Practice location:
  • Phone: 714-638-1358
  • Fax: 714-741-0693
Mailing address:
  • Phone: 714-777-1710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA33306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: