Kenneth Ian Light in San Leandro - Specialist
Kenneth Ian Light - NPI 1104900919
Kenneth Ian Light is a Specialist in San Leandro, California. Kenneth Ian Light practices all healthcare services and medical treatments related to Specialist. The NPI Number for Kenneth Ian Light is 1104900919. The last update date is 2022-07-19.
Kenneth Ian Light's current location address is 13847 E 14th St Ste 118, San Leandro, California. You can contact this provider via phone number 4156734500. The mailing address for Kenneth Ian Light is 13847 E 14th St Ste 118, San Leandro, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Ian Light |
|---|---|
| Address | 13847 E 14th St Ste 118, San Leandro, California |
| Phone Number | 4156734500 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1104900919 |
|---|---|
| Provider Enumeration Date | 2006-10-25 |
| Last Updated Date | 2022-07-19 |
Provider Mailing Address Detail
| Address | 13847 E 14th St Ste 118 |
|---|---|
| City | San Leandro |
| State | California (CA) |
| Post Code | 945782625 |
| Phone Number | 4156734500 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | G35263 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Post Comment/ Review Below
What is the unique identifier code issued to Kenneth Ian Light by the Centers for Medicare & Medicaid Services?
The Kenneth Ian Light has been assigned the NPI (National Provider Identifier) 1104900919. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Kenneth Ian Light's physical address?
The Kenneth Ian Light is physically located at 13847 E 14Th St Ste 118, in the city of San Leandro, CA, with the postal code 945782625.
What is Kenneth Ian Light's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kenneth Ian Light is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1104900919 to Kenneth Ian Light?
The Centers for Medicare & Medicaid Services assigned the 1104900919 to Kenneth Ian Light on 2006-10-25.
As of what date was the information pertaining to Kenneth Ian Light, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kenneth Ian Light, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2022-07-19.
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