Individual
ANTIEM BUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3300 E SOUTH ST STE 308, LAKEWOOD, CA 90805-4598
(562) 630-3111
Mailing address
3300 E SOUTH ST STE 308, LAKEWOOD, CA 90805-4598
(562) 630-3111
(562) 630-3107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A15461
CA
207R00000X
Internal Medicine Physician
58.006051
OH
207RN0300X
Nephrology Physician
Primary
20A15461
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A15461
OSTEOPATHIC PHYSICIAN AND SURGEON
CA
Enumeration date
04/17/2014
Last updated
02/20/2025
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