Individual
DR. DERRICK LAMONT BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3834 S WESTERN AVE, LOS ANGELES, CA 90062-1104
(323) 730-1920
(323) 730-1504
Mailing address
3834 S WESTERN AVE, LOS ANGELES, CA 90062-1104
(323) 730-1920
(323) 730-1504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A67268
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A672680
—
CA
Enumeration date
06/17/2006
Last updated
01/28/2011
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