Individual provider Active NPI

Lan Bach Bui, PA-C

  • Medical Physician Assistant
  • Anaheim, CA
National Provider Identifier
1093770976
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18388 Issued in CA
Practice address
1814 W Lincoln Ave
Anaheim, CA 92801-6730
Phone
(714) 780-5690
Fax
(714) 780-5696
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA18388 CA Primary

Addresses

Primary practice location

1814 W Lincoln Ave
Anaheim, CA 92801-6730

Mailing address

1814 W Lincoln Ave
Anaheim, CA 92801-6730
Phone (714) 780-5690

Other identifiers 1

IdentifierTypeStateIssuer
1093770976MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000641 CA Order and Referring Only - Physician Assistant 4688822547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18388CAMDMedical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1093770976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 W LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016730",
            "telephone_number": "714-780-5690",
            "fax_number": "714-780-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 W LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016730",
            "telephone_number": "714-780-5690",
            "fax_number": "714-780-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "LAN",
        "middle_name": "BACH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093770976",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.