Provider Demographics
NPI:1851615603
Name:BUTERA, ANNA-MARIA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNA-MARIA
Middle Name:
Last Name:BUTERA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BUTERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:18406 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4107
Mailing Address - Country:US
Mailing Address - Phone:818-885-5480
Mailing Address - Fax:
Practice Address - Street 1:18406 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4107
Practice Address - Country:US
Practice Address - Phone:818-885-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11928390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program