| Phong H Bui Inc | |
|
16055 Brookhurst St Suite C Fountain Valley CA 92708-1544 | |
| (714) 839-2400 | |
| (714) 839-2401 |
| Full Name | Phong H Bui Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16055 Brookhurst St, Fountain Valley, California |
| Authorized Official Name and Position | Phong H Bui (MD/PRESIDENT) |
| Authorized Official Contact | 7149259380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phong H Bui Inc 16055 Brookhurst St Suite C Fountain Valley CA 92708-1544 Ph: (714) 839-2400 | Phong H Bui Inc 16055 Brookhurst St Suite C Fountain Valley CA 92708-1544 Ph: (714) 839-2400 |
| NPI Number | 1770909830 |
|---|---|
| Provider Enumeration Date | 03/13/2014 |
| Last Update Date | 12/04/2020 |
| Medicare PECOS PAC ID | 0143440388 |
|---|---|
| Medicare Enrollment ID | O20141009002356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770909830 | NPI | - | NPPES |
| A101682 | Other | CA | LICENCE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A101682 (California) | Secondary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Phong Huy Bui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316177462 PECOS PAC ID: 7416093935 Enrollment ID: I20091013000745 |
| Provider Name | Miki Kaneko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750772000 PECOS PAC ID: 1557671377 Enrollment ID: I20160415001487 |
| Provider Name | Christine Kha |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1851784763 PECOS PAC ID: 2264850908 Enrollment ID: I20200914000659 |
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