Provider Demographics
NPI:1891808804
Name:BUI, RAU VAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAU
Middle Name:VAN
Last Name:BUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAU
Other - Middle Name:VAN
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:27 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-2022
Mailing Address - Country:US
Mailing Address - Phone:408-298-6706
Mailing Address - Fax:408-971-2696
Practice Address - Street 1:27 S 13TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2022
Practice Address - Country:US
Practice Address - Phone:408-298-6706
Practice Address - Fax:408-971-2696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA035749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA27895Medicare UPIN
CA00357490Medicare ID - Type Unspecified