Provider Demographics
NPI:1912133521
Name:BUTLER, KAREN ELISE (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELISE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10925 BLIX ST
Mailing Address - Street 2:#301
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3816
Mailing Address - Country:US
Mailing Address - Phone:818-623-0212
Mailing Address - Fax:
Practice Address - Street 1:10925 BLIX ST
Practice Address - Street 2:#301
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-3816
Practice Address - Country:US
Practice Address - Phone:818-623-0212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8739208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice