MEDICARE: MR. KHIET BUI RPH

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	183500000X	Pharmacist	RPH47937	CA

General Provider Information

NPI Number	:	1285762708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KHIET BUI RPH

Provider Business Mailing Address
First Line	:	PO BOX 5487
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92165-5487
Country	:	US
Telephone Number	:	619-501-8046
Fax Number	:

Provider Business Practice Location Address
First Line	:	5065 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-3348
Country	:	US
Telephone Number	:	619-501-8046
Fax Number	:

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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