Provider Demographics
NPI:1861832180
Name:BUI, LINDA MAI (OD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MAI
Last Name:BUI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1063 NEWPORT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6945
Mailing Address - Country:US
Mailing Address - Phone:949-966-1585
Mailing Address - Fax:949-315-3145
Practice Address - Street 1:1063 NEWPORT CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-966-1585
Practice Address - Fax:949-315-3145
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007979152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist