Individual
MIKE QUYNH BUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1125 E 17TH ST, S102, SANTA ANA, CA 92701-2201
(714) 999-0075
Mailing address
1125 E 17TH ST, S102, SANTA ANA, CA 92701-2201
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47028
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0538871
NCPDP #
CA
05
—
PHA470280
—
CA
Enumeration date
12/07/2007
Last updated
03/07/2023
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