Provider Demographics
NPI:1275858409
Name:BUI-DUY, MAI-KHANH (MD)
Entity Type:Individual
Prefix:DR
First Name:MAI-KHANH
Middle Name:
Last Name:BUI-DUY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E BEACH ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4809
Mailing Address - Country:US
Mailing Address - Phone:831-728-0222
Mailing Address - Fax:
Practice Address - Street 1:45 NEILSON ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2468
Practice Address - Country:US
Practice Address - Phone:831-728-0222
Practice Address - Fax:831-707-0277
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119506207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine