Provider Demographics
NPI:1851900948
Name:BUI, DENNY MINH
Entity Type:Individual
Prefix:
First Name:DENNY
Middle Name:MINH
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 1:5325 W LUCKY WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1047
Mailing Address - Country:US
Mailing Address - Phone:714-200-5246
Mailing Address - Fax:
Practice Address - Street 1:24261 AVENIDA DE LA CARLOTA STE Q2
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7633
Practice Address - Country:US
Practice Address - Phone:949-588-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist