Provider Demographics
NPI:1871844688
Name:BUI, KAY KHANH (HAD)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:KHANH
Last Name:BUI
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 N HARBOR BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4129
Mailing Address - Country:US
Mailing Address - Phone:714-870-4822
Mailing Address - Fax:714-870-4804
Practice Address - Street 1:1321 N HARBOR BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4129
Practice Address - Country:US
Practice Address - Phone:714-870-4822
Practice Address - Fax:714-870-4804
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7651237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist