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General NPI Number Information
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NPI Number | 1770909830
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Entity Type | Organization
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Legal Business Name | PHONG H BUI INC
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 16055 BROOKHURST ST SUITE C
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-1544
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Country | US
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Telephone | 714-839-2400
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Fax | 714-839-2401
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Provider Business Mailing Address
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Address Line | 16055 BROOKHURST ST SUITE C
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-1544
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Country | US
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Telephone | 714-839-2400
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Fax |
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | PHONG H BUI
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Credential | DO
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Telephone | 714-925-9380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A101682
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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