Active NPI
Ethan Lichtblau, MD
- Orthopaedic Surgery Physician
- Chico, CA
National Provider Identifier
1114126158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G88013
- Practice address
- 1531 The Esplanade
Chico, CA 95926-3310 - Phone
- (530) 332-7300
- NPI assigned
- Jul 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G88013 | CA | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 10692 | ND |
Addresses
Primary practice location
1531 The Esplanade
Chico, CA 95926-3310
Mailing address
1531 The Esplanade
Chico, CA 95926-3310
Phone (530) 332-7300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G88013 | Other | CA | CA LICENSE |
| 14386 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88013 | CA | MD | Social Worker |
| G88013 | CA | MD | Orthopaedic Surgery Physician |
| 10692 | ND | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield on-Call Specialists PC | Orthopaedic Surgery | Past | Accepting new patients |
| Elwood Paul Reid MD Inc | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Grass Valley, CA
- NPI 1639331341
-
- Obstetrics & Gynecology Physician
- Fairfield, CA
- NPI 1588849491
Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1114126158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1531 THE ESPLANADE",
"city": "CHICO",
"state": "CA",
"postal_code": "959263310",
"telephone_number": "530-332-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1531 THE ESPLANADE",
"city": "CHICO",
"state": "CA",
"postal_code": "959263310",
"telephone_number": "530-332-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHTBLAU",
"first_name": "ETHAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-11",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G88013",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "ND",
"license": "10692",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA LICENSE",
"identifier": "G88013",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "14386",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.