Provider Demographics
NPI:1578657573
Name:BUTTINO, LYNN M (OD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:M
Last Name:BUTTINO
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Gender:F
Credentials:OD
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Mailing Address - Street 1:9727 ELK GROVE FLORIN RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2264
Mailing Address - Country:US
Mailing Address - Phone:916-686-5165
Mailing Address - Fax:916-686-5865
Practice Address - Street 1:9727 ELK GROVE FLORIN RD
Practice Address - Street 2:SUITE 190
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2264
Practice Address - Country:US
Practice Address - Phone:916-686-5165
Practice Address - Fax:916-686-5865
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-05-21
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Provider Licenses
StateLicense IDTaxonomies
CA9871T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU52418Medicare UPIN