Provider Demographics
NPI:1417914375
Name:BEUTLER, DEBORAH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:BEUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 E WOODLYN RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-3445
Mailing Address - Country:US
Mailing Address - Phone:626-797-8399
Mailing Address - Fax:
Practice Address - Street 1:675 S ARROYO PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3263
Practice Address - Country:US
Practice Address - Phone:626-243-5211
Practice Address - Fax:626-844-0399
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG067367207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine