MEDICARE: TIMOTHY BUI

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
1	225200000X	Physical Therapy Assistant	51280	CA

General Provider Information

NPI Number	:	1194453605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY BUI

Provider Business Mailing Address
First Line	:	1613 W HOUSTON AVE
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-4503
Country	:	US
Telephone Number	:	562-246-8590
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 W HOUSTON AVE
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-4503
Country	:	US
Telephone Number	:	562-246-8590
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	08/11/2022

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Directions to “ TIMOTHY BUI ” Practice Location

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