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NPI 1487449500

NPI 1487449500 : MATTHEW BUI : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1487449500
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    Entity Type          |    Individual 
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    Provider Name        |    MATTHEW BUI
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    Gender               |     
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Dates
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    Enumeration Date     |    04/10/2025
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    Last Update Date     |    06/23/2025
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Provider Practice Location Address
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    Address Line         |    155 5TH ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94103-2919
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    Country              |    US
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    Telephone            |    415-929-6501
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3170 W OLYMPIC BLVD 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90006-2400
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    Country              |    US
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    Telephone            |    408-724-0175
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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