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NPI Code Detail

MEDICARE: DR. MANISH JANARDHAN BUTTE M.D., PH.D.

MEDICARE: DR. MANISH JANARDHAN BUTTE M.D., PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology PhysicianA110453CA
22080P0201XPediatric Allergy/Immunology PhysicianA110453CA

General Provider Information

NPI Number : 1801861216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANISH JANARDHAN BUTTE M.D., PH.D.
Provider Business Mailing Address
First Line : 221 WESTWOOD PLZ
Second Line : BOX 951556
City : LOS ANGELES
State : CA
Zip : 90095-1556
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 951556
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-2200
Country : US
Telephone Number : 310-825-0768
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 05/31/2017

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