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NPI Code Detail

MEDICARE: CHAU QUYNH BUI D.O.

MEDICARE: CHAU QUYNH BUI D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20A14247CA
2207QS0010XSports Medicine (Family Medicine) Physician20A14247CA
3208M00000XHospitalist Physician20A14247CA

General Provider Information

NPI Number : 1194142562
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAU QUYNH BUI D.O.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 514 N PROSPECT AVE STE 103
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-3037
Country : US
Telephone Number : 310-937-8555
Fax Number : 310-937-8556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2014
Last Update Date : 01/02/2020

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