Licht, Jonathan M
Licht, Jonathan M is an sole proprietor health care provider with primary practice located at 4033 3Rd Ave Suite 206, San Diego CA 92103-2117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Licht, Jonathan M can be contacted via phone (619) 294-9292.Contact Information
Primary practice address
4033 3Rd Ave Suite 206
San Diego CA 92103-2117
Phone: (619) 294-9292
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G43892 | California |
Profile Details
NPI number | 1356321988 |
---|---|
LBN Legal business name | Licht, Jonathan M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 19th, 2006 |
Last updated | Jan 11th, 2010 - about 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1356321988 | NPPES |
California | MEDICAID | 00G438921 |
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