Lightfoot, Dan R

Lightfoot, Dan R is an individual health care provider with primary practice located at 720 4Th St , Santa Rosa CA 95404-4421. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Lightfoot, Dan R can be contacted via phone (707) 575-3800.

Contact Information

Primary practice address
720 4Th St Santa Rosa CA 95404-4421
Phone: (707) 575-3800
Fax: (707) 528-4967
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G32243 California

Profile Details

NPI number 1023008075
LBN Legal business name Lightfoot, Dan R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Jul 1st, 2008 - about 16 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 1023008075 NPPES
California Other B002 CHAMPUS
California MEDICAID 00G322430 CHAMPUS
California Other 180009844 CHAMPUS

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