Provider Demographics
NPI:1023081387
Name:BUI, LOC DAC (MD)
Entity type:Individual
Prefix:DR
First Name:LOC
Middle Name:DAC
Last Name:BUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 BOLSA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5475
Mailing Address - Country:US
Mailing Address - Phone:714-897-2623
Mailing Address - Fax:714-379-0343
Practice Address - Street 1:8900 BOLSA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5475
Practice Address - Country:US
Practice Address - Phone:714-897-2623
Practice Address - Fax:714-379-0343
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A501980Medicaid
CAF49622Medicare UPIN