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NPI Code Detail

MEDICARE: DONALD MICHAEL BUTERA D.C.

MEDICARE: DONALD MICHAEL BUTERA D.C.
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
1111N00000XChiropractor11278CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DC11278OTHERCACHIROPRACTIC LICENSE

General Provider Information

NPI Number : 1881880318
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD MICHAEL BUTERA D.C.
Provider Business Mailing Address
First Line : 15550 ROCKFIELD BLVD
Second Line : B220
City : IRVINE
State : CA
Zip : 92618-2720
Country : US
Telephone Number : 949-598-9999
Fax Number : 949-598-9990
Provider Business Practice Location Address
First Line : 367 EL CAMINO REAL
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-5923
Country : US
Telephone Number : 650-583-4719
Fax Number : 650-583-4727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2007
Last Update Date : 09/16/2010

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