Provider Demographics
NPI:1790160299
Name:BUI, THIN VIET (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:THIN
Middle Name:VIET
Last Name:BUI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 GOLDEN STATE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4117
Mailing Address - Country:US
Mailing Address - Phone:714-548-0506
Mailing Address - Fax:
Practice Address - Street 1:425 GOLDEN STATE AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4114
Practice Address - Country:US
Practice Address - Phone:661-859-1028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-25
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN95001476363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care