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General NPI Number Information
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NPI Number | 1053632034
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Entity Type | Individual
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Provider Name | IAN B BUTLER MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 3231 WARING CT STE D
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City | OCEANSIDE
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State | CA
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Zip | 92056-4510
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Country | US
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Telephone | 760-941-0221
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Fax | 760-941-0905
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Provider Business Mailing Address
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Address Line | 3231 WARING CT STE D
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City | OCEANSIDE
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State | CA
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Zip | 92056-4510
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Country | US
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Telephone | 760-941-0221
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Fax | 760-941-0905
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | H5896
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | C137716
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | MD439803
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD439803
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License Number State | PA
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