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General NPI Number Information
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NPI Number | 1851705842
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Entity Type | Individual
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Provider Name | MARTIN ANH DUC BUI PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 12815 HEACOCK ST
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3116
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Country | US
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Telephone | 951-601-6006
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Fax | 951-601-6058
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Provider Business Mailing Address
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Address Line | 10976 SAN PASQUAL AVE
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City | MONTCLAIR
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State | CA
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Zip | 91763-6086
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Country | US
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Telephone | 562-237-8774
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH 57813
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License Number State | CA
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