Provider Demographics
NPI:1750874608
Name:BUI, JOSEPH HIEN TRUNG (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH HIEN
Middle Name:TRUNG
Last Name:BUI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7596 EDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3570
Mailing Address - Country:US
Mailing Address - Phone:657-329-2729
Mailing Address - Fax:714-375-7193
Practice Address - Street 1:7596 EDINGER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3570
Practice Address - Country:US
Practice Address - Phone:657-329-2729
Practice Address - Fax:714-375-7193
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33952152WP0200X, 152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33952OtherSTATE LICENSE