Provider Demographics
NPI:1699183103
Name:BUI, QUY
Entity Type:Individual
Prefix:
First Name:QUY
Middle Name:
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 1:40500 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6403
Mailing Address - Country:US
Mailing Address - Phone:951-696-4513
Mailing Address - Fax:951-696-4516
Practice Address - Street 1:40500 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6403
Practice Address - Country:US
Practice Address - Phone:951-696-4513
Practice Address - Fax:951-696-4516
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist