Provider Demographics
NPI:1316204654
Name:BUTANI, VIRIT DILIP (DPM)
Entity Type:Individual
Prefix:DR
First Name:VIRIT
Middle Name:DILIP
Last Name:BUTANI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 UCLA MEDICAL PLZ
Mailing Address - Street 2:SUITE 460
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-6909
Mailing Address - Country:US
Mailing Address - Phone:310-433-8999
Mailing Address - Fax:310-208-4847
Practice Address - Street 1:100 UCLA MEDICAL PLZ
Practice Address - Street 2:SUITE 460
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-6909
Practice Address - Country:US
Practice Address - Phone:310-433-8999
Practice Address - Fax:310-208-4847
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAE5173213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program