Larry Brock Butler, PA

NPI #1073138103 in Vista, California

Provider Information

NPI Number: 1073138103
Entity Type: Individual
Name: Larry Brock Butler, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 15, 2020
Last Updated: Jun 2, 2022

Practice Location

Address: 130 CEDAR RD
City: Vista
State: California
ZIP Code: 92083-5102
Phone: (760) 806-5500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Physician Assistant	363A00000X	Primary

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