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ANTIEM BUI D.O.
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1336569300
Individual Registrant: ANTIEM BUI D.O.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
3300 E SOUTH ST STE 308 LAKEWOOD, CA 90805-4598 US
Tel: 562-630-3111 Fax: --
Tel: 562-630-3111 Fax: --
Contact information for business:
667 EASTLAND AVE SE WARREN, OH 44484-4503 US
Tel: 330-841-4000 Fax: --
Tel: 330-841-4000 Fax: --
Registration Information:
NPI: 1336569300
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | OH | 58.006051 |
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | CA | 20A15461 |
| N | 390200000X | Student Organized Health Care Education/Training Program |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| OSTEOPATHIC PHYSICIAN AND SURGEON | 20A15461 | CA | 01 |
