Provider Demographics
NPI:1023453966
Name:BUTALA, NEETI (MD)
Entity type:Individual
Prefix:
First Name:NEETI
Middle Name:
Last Name:BUTALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NEETI
Other - Middle Name:
Other - Last Name:ARORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9800 VESPER AVE
Mailing Address - Street 2:#105
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-1049
Mailing Address - Country:US
Mailing Address - Phone:818-515-8483
Mailing Address - Fax:
Practice Address - Street 1:9800 VESPER AVE
Practice Address - Street 2:#105
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-1049
Practice Address - Country:US
Practice Address - Phone:818-515-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA148500207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology