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General NPI Number Information
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NPI Number | 1841031911
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Entity Type | Individual
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Provider Name | KATHLEEN MINH KHANH BUI-NGUYEN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 7172 EDINGER AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3505
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Country | US
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Telephone | 714-902-9349
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Fax |
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Provider Business Mailing Address
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Address Line | 17553 CLOVERDALE WAY
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City | YORBA LINDA
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State | CA
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Zip | 92886-1949
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 305966
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License Number State | CA
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