Provider Demographics
NPI:1013957125
Name:BUI, BRIAN A (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:BUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:SUITE E-130
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9151
Mailing Address - Country:US
Mailing Address - Phone:951-894-1131
Mailing Address - Fax:
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:#E-130
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9101
Practice Address - Country:US
Practice Address - Phone:951-894-1131
Practice Address - Fax:951-696-6742
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67716174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF11254Medicare UPIN