Hetland, Robert Lytton

Hetland, Robert Lytton is an sole proprietor health care provider with primary practice located at 1395 San Carlos Ave Suite A, San Carlos CA 94070-2388. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Hetland, Robert Lytton can be contacted via phone (650) 802-9921.

Contact Information

Primary practice address
1395 San Carlos Ave Suite A San Carlos CA 94070-2388
Phone: (650) 802-9921
Fax: (650) 802-9923
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X A22540 California

Profile Details

NPI number 1174558985
LBN Legal business name Hetland, Robert Lytton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2006
Last updated Jun 22nd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174558985 NPPES
California Other 11002645 CAQH PROVIDER ID
California Other 4056691 CAQH PROVIDER ID
California MEDICAID 00A225400 CAQH PROVIDER ID
California Other P00205050 CAQH PROVIDER ID

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