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General NPI Number Information
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NPI Number | 1245531649
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Entity Type | Organization
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Legal Business Name | LOC DAC BUI M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 8900 BOLSA AVE STE B
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City | WESTMINSTER
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State | CA
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Zip | 92683-5475
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Country | US
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Telephone | 714-897-2623
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Fax | 714-379-0343
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Provider Business Mailing Address
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Address Line | 8900 BOLSA AVE SUITE B
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City | WESTMINSTER
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State | CA
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Zip | 92683-5474
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Country | US
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Telephone | 714-897-2623
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Fax | 714-379-0343
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOC DAC BUI
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Credential | M.D.
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Telephone | 714-897-2623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A50198
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License Number State | CA
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