Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A35748 | CA |
NPI | 1023116498 |
---|---|
Provider Name | Dong Bui |
First Address | Westminster, CA 92683-5986 |
Second Address | Westminster, CA 92683-5986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A357480 | (05) | CA |
A84808 | (02) |