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General NPI Number Information
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NPI Number | 1457752842
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Entity Type | Individual
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Provider Name | LAURA BUTNER PA
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Gender | Female
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Dates
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Enumeration Date | 09/04/2014
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1840 WEST DR
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City | VISTA
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State | CA
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Zip | 92083-6115
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Country | US
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Telephone | 240-321-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 210 N TUSTIN AVE
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City | SANTA ANA
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State | CA
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Zip | 92705-3807
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 9108122
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA57852
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License Number State | CA
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