Individual
MR. ANDREW THANH BUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
162 1ST ST, PORT HUENEME, CA 93043-4316
(805) 982-2731
Mailing address
162 1ST ST, PORT HUENEME, CA 93043-4316
(805) 982-2731
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
19005-10A
CA
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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