Individual ProviderLisa ButhPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9850 Genesee Ave Ste 110, La Jolla, CA 92037-1206(858) 626-5546PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Buth does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1023659828Provider TypeIndividualFull NameButh, LisaCredentialDPTGenderFemaleSole ProprietorYesEnumeration Date10/2/2019Last Updated4/25/2023Contact InformationPractice LocationPractice Address9850 Genesee Ave Ste 110, La Jolla, CA 92037-1206Phone(858) 626-5546FaxUnlisted FaxMailing LocationMailing Address10790 Rancho Bernardo Rd, San Diego, CA 92127-5705Phone(858) 626-5546FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense19634California