Provider Demographics
NPI:1730320763
Name:BUTT, OLIVIA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:BUTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 S SHORE CTR W STE D
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5759
Mailing Address - Country:US
Mailing Address - Phone:510-864-0660
Mailing Address - Fax:510-864-0393
Practice Address - Street 1:501 S SHORE CTR W STE D
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5759
Practice Address - Country:US
Practice Address - Phone:510-864-0660
Practice Address - Fax:510-864-0393
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-21
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106483207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology