Provider Demographics
NPI:1093875361
Name:BUI, MINH Q (MD)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:Q
Last Name:BUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:Q
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:631 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-5427
Mailing Address - Country:US
Mailing Address - Phone:805-452-9150
Mailing Address - Fax:
Practice Address - Street 1:631 COOPER RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-5427
Practice Address - Country:US
Practice Address - Phone:805-452-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A352181Medicaid
CAC03938Medicare UPIN
CAA35218AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER