Provider Demographics
NPI:1174015580
Name:BUI, AIKEN K (RPH)
Entity Type:Individual
Prefix:DR
First Name:AIKEN
Middle Name:K
Last Name:BUI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 BLUE HERON
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-5611
Mailing Address - Country:US
Mailing Address - Phone:949-372-8073
Mailing Address - Fax:
Practice Address - Street 1:700 S GAFFEY ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3029
Practice Address - Country:US
Practice Address - Phone:310-514-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist