Provider Demographics
NPI:1508849845
Name:BUI, HANA THANH (MD)
Entity Type:Individual
Prefix:DR
First Name:HANA
Middle Name:THANH
Last Name:BUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HANG
Other - Middle Name:THANH
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1321 N HARBOR BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4129
Mailing Address - Country:US
Mailing Address - Phone:714-870-4822
Mailing Address - Fax:714-870-4804
Practice Address - Street 1:1321 N HARBOR BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4129
Practice Address - Country:US
Practice Address - Phone:714-870-4822
Practice Address - Fax:714-870-4804
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG064344207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF38349Medicare UPIN