Light, Eliot S

Light, Eliot S is an sole proprietor health care provider with primary practice located at 621 Forest Ave , Pacific Grove CA 93950. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Light, Eliot S can be contacted via phone (831) 649-1011.

Contact Information

Primary practice address
621 Forest Ave Pacific Grove CA 93950
Phone: (831) 649-1011
Fax: (831) 373-8201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C40086 California

Profile Details

NPI number 1942382577
LBN Legal business name Light, Eliot S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2006
Last updated Sep 30th, 2020 - about 6 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 1942382577 NPPES
Other 770046058 BLUE SHIELD AND ALL OTHER
Other 00G400860 BLUE SHIELD AND ALL OTHER
MEDICAID 00G400860 BLUE SHIELD AND ALL OTHER

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