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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1356321988 NPPES
California MEDICAID 00G438921

Popular Providers