Provider Demographics
NPI:1003197294
Name:THUO, BUI MUTURI (RN)
Entity Type:Individual
Prefix:
First Name:BUI
Middle Name:MUTURI
Last Name:THUO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20535 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-8380
Mailing Address - Country:US
Mailing Address - Phone:951-776-7446
Mailing Address - Fax:
Practice Address - Street 1:20535 LAKERIDGE DR
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-8380
Practice Address - Country:US
Practice Address - Phone:951-776-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse