Provider Demographics
NPI:1881276863
Name:BUTANI, JAY KARSHAN
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:KARSHAN
Last Name:BUTANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3034
Mailing Address - Country:US
Mailing Address - Phone:818-599-6140
Mailing Address - Fax:
Practice Address - Street 1:189 S TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-2292
Practice Address - Country:US
Practice Address - Phone:805-967-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH84257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist