Provider Demographics
NPI:1558074120
Name:BUI, DANNY QUANG
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:QUANG
Last Name:BUI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12410 SEAL BEACH BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2788
Mailing Address - Country:US
Mailing Address - Phone:562-516-3339
Mailing Address - Fax:
Practice Address - Street 1:12410 SEAL BEACH BLVD STE F
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2788
Practice Address - Country:US
Practice Address - Phone:562-516-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA64235363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program