Provider Demographics
NPI:1083943112
Name:BUI, TOM (PHARMD)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32671 RED MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-8209
Mailing Address - Country:US
Mailing Address - Phone:408-881-4607
Mailing Address - Fax:
Practice Address - Street 1:32671 RED MAPLE ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-8209
Practice Address - Country:US
Practice Address - Phone:408-881-4607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-20
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60992183500000X
TX42051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist