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Individual
KIM JOHNSON BUTLER
Active
Individual
KIM JOHNSON BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT6405TPA
CA
152WC0802X
Corneal and Contact Management Optometrist
OPT6405TPA
CA
152WX0102X
Occupational Vision Optometrist
OPT6405TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0064050
—
CA
05
—
SD0064051
—
CA
Enumeration date
08/22/2005
Last updated
07/24/2009
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