Individual
SON LAC BUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 S RAINBOW BLVD # B, LAS VEGAS, NV 89145-6231
(702) 255-4200
(702) 255-0260
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 507-2430
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
930
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205861820
—
NV
01
—
930
STATE LICENSE
NV
Enumeration date
07/12/2006
Last updated
10/17/2022
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