Individual
KATHLEEN BEUTTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3085 LOMA VISTA RD, VENTURA, CA 93003-2916
(805) 648-3085
(805) 648-7027
Mailing address
3085 LOMA VISTA RD, VENTURA, CA 93003-2916
(805) 648-3085
(805) 648-7027
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C41709
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180036165
RAILROAD MEDICARE
CA
01
—
205153800
US DEPT. OF LABOR
CA
01
—
C417090
BLUE SHIELD
CA
05
—
GR0076890
—
CA
01
—
WC41709B
DMERC
CA
Enumeration date
06/15/2006
Last updated
07/08/2010
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