Individual
JEREMIAH BUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5000
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
PTL1114
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
11/29/2021
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