MR. JONATHAN M LICHT (NPI# 1356321988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356321988 |
| Entity Type | Individual |
| Full Name | MR. JONATHAN M LICHT |
| Credential | MD |
| Practice Address |
4033 3rd Ave Suite 206 San Diego CA 92103-2117 |
| Practice Telephone | 6192949292 |
| Mailing Telephone | 6192949292 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2010-01-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
G43892 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G438921 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720158116 | Jonathan Licht | Internal Medicine | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-11-09 |
| Street Address |
4033 3RD AVE SUITE 206 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871579722 | Scripps Clinic Medical Group | Clinic/Center | 4033 3rd Ave, Suite 210, San Diego, CA 92103-2117 | 2005-12-21 |
| 1811340227 | Sudhir Malik, A Professional Medical Corporation | Psychiatry & Neurology | 4033 3rd Ave, Suite 206, San Diego, CA 92103-2117 | 2016-07-20 |
| 1578972782 | Hillcrest Hearing Center | Hearing Aid Equipment | 4033 3rd Ave, Ste 104, San Diego, CA 92103-2117 | 2014-08-13 |
| 1659673994 | Gilda Tafreshi, Md, Inc. | Psychiatry & Neurology | 4033 3rd Ave, Suite 206, San Diego, CA 92103-2117 | 2010-11-18 |
| 1912217522 | Paul M Goodman Md A Medical Corporation | Otolaryngology | 4033 3rd Ave, Suite 104, San Diego, CA 92103-2117 | 2010-10-15 |
| 1700100369 | Pierre G Rivet Md A Medical Corporation | Otolaryngology | 4033 3rd Ave, Suite 104, San Diego, CA 92103-2117 | 2010-03-25 |
| 1326370677 | Pacific Coast Surgical Group | Surgery | 4033 3rd Ave, Suite204, San Diego, CA 92103-2117 | 2010-02-10 |
| 1972757045 | Hillcrest Hearing Center Inc | Audiologist | 4033 3rd Ave, Suite 104, San Diego, CA 92103-2117 | 2008-11-16 |
| 1447443809 | Paul Alvord | Transplant Surgery | 4033 3rd Ave, Suite 204, San Diego, CA 92103-2117 | 2007-08-20 |
| 1366657603 | Cynthia Crist | Nurse Practitioner | 4033 3rd Ave, Suite 300, San Diego, CA 92103-2117 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902451263 | Kimberly M. Sandberg, Rn, Cran, A Professional Corporation | Psychiatry & Neurology | 4520 Executive Dr Ste 227, San Diego, CA 92121-3020 | 2019-08-05 |
| 1992261374 | Del Mar Brain & Neurostar Tms Inc. | Psychiatry & Neurology | 12264 El Camino Real Ste 202, San Diego, CA 92130-3061 | 2019-02-11 |
| 1225579006 | Lg Aguilar Tabora, Md Inc | Psychiatry & Neurology | 8650 Genessee Ave. Ste 214, #8684, San Diego, CA 92192-8684 | 2017-03-14 |
| 1851725600 | Calneuros, A Professional Medical Corporation | Psychiatry & Neurology | 16766 Bernardo Center Dr Ste 213, San Diego, CA 92128 | 2013-08-29 |
| 1396010856 | Bertrand Liang | Psychiatry & Neurology | 10357 Longdale Pl, San Diego, CA 92131-6126 | 2012-03-16 |
| 1548530157 | Richard Irwin Rowen | Psychiatry & Neurology | 5482 Drover Dr, San Diego, CA 92115-1127 | 2012-01-12 |
| 1457583825 | Leonard J. Gosink | Psychiatry & Neurology | 2403 Romney Rd, San Diego, CA 92109-1559 | 2009-08-18 |
| 1205068210 | David J Croteau | Psychiatry & Neurology | 150 W Washington St Fl 2, San Diego, CA 92103-2005 | 2009-08-10 |
| 1326290339 | Monali Sarjan Patel | Psychiatry & Neurology | 7625 Mesa College Dr Ste 200a, San Diego, CA 92111-5343 | 2008-10-21 |
| 1215188701 | Brenton Alan Wright | Psychiatry & Neurology | 4510 Executive Dr Ste 325, San Diego, CA 92121-3069 | 2008-10-02 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.