| Michael L Butera Md Inc | |
|
6699 Alvarado Rd Ste 2309 San Diego CA 92120-5241 | |
| (619) 286-8803 | |
| (619) 286-2344 |
| Full Name | Michael L Butera Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6699 Alvarado Rd Ste 2309, San Diego, California |
| Authorized Official Name and Position | Michael Lawrence Butera (PRESIDENT) |
| Authorized Official Contact | 6192868803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael L Butera Md Inc Po Box 1009 Spring Valley CA 91979-1009 Ph: (619) 508-0908 | Michael L Butera Md Inc 6699 Alvarado Rd Ste 2309 San Diego CA 92120-5241 Ph: (619) 286-8803 |
| NPI Number | 1013016112 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 04/17/2023 |
| Medicare PECOS PAC ID | 4880784271 |
|---|---|
| Medicare Enrollment ID | O20071221000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013016112 | NPI | - | NPPES |
| 00G702380 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Michael L Butera |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104925205 PECOS PAC ID: 5092775528 Enrollment ID: I20041018001285 |
| Provider Name | Jessica Cable Merchant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023627494 PECOS PAC ID: 8628488772 Enrollment ID: I20201102001159 |
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