Provider Demographics
NPI:1598183790
Name:BUI, PEGGY (MD MBA)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:BUI
Suffix:
Gender:F
Credentials:MD MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 DIVISADERO ST FL 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3425
Mailing Address - Country:US
Mailing Address - Phone:415-353-7900
Mailing Address - Fax:
Practice Address - Street 1:1545 DIVISADERO ST FL 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3425
Practice Address - Country:US
Practice Address - Phone:415-353-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA141064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine