Organization
MIKE QUYNH BUI
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BUI (OWNER/PHARMACIST)
(714) 999-0075
Entity
Organization
Contact information
Practice address
1125 E 17TH ST STE N155, SANTA ANA, CA 92701-2215
(714) 999-0075
(714) 999-0076
Mailing address
1125 E 17TH ST STE N155, SANTA ANA, CA 92701-2215
(714) 999-0075
(714) 999-0076
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
52530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149222
PK
—
Enumeration date
01/14/2015
Last updated
08/28/2020
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