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NPI Code Detail

MEDICARE: TARA BUI MA

MEDICARE: TARA BUI MA
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
1106H00000XMarriage & Family Therapist114563CA
2106H00000XMarriage & Family TherapistLMFT114563CA

General Provider Information

NPI Number : 1790105419
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA BUI MA
Provider Business Mailing Address
First Line : 130 VALLEY ST UNIT 4021
Second Line :
City : PASADENA
State : CA
Zip : 91105-4164
Country : US
Telephone Number : 626-484-5531
Fax Number :
Provider Business Practice Location Address
First Line : 4325 W SUNSET BLVD STE 206
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-2180
Country : US
Telephone Number : 626-484-5531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2014
Last Update Date : 01/14/2020

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Directions to “ TARA BUI MA” Practice Location

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