Provider Demographics
NPI:1689939944
Name:BUI, TRUNG-HUNG THO
Entity Type:Individual
Prefix:DR
First Name:TRUNG-HUNG
Middle Name:THO
Last Name:BUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15191 STARBOARD ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-5211
Mailing Address - Country:US
Mailing Address - Phone:714-251-4931
Mailing Address - Fax:
Practice Address - Street 1:10512 BOLSA AVE
Practice Address - Street 2:101
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6727
Practice Address - Country:US
Practice Address - Phone:714-554-8784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29040111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner