Individual
STEWART BRUCE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(760) 207-7772
Mailing address
1134 PALAU RD, CORONADO, CA 92118-3132
(760) 207-7772
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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