Mark W Light, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G32061 Issued in CA

Practice address

1279 E 1St Ave
Ste C
Chico, CA 95926-1542

Phone

(530) 899-7300

Fax

(530) 899-7211

NPI assigned

Jun 16, 2005

Last updated

May 21, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1427053388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 E 1ST AVE",
            "address_2": "STE C",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261542",
            "telephone_number": "530-899-7300",
            "fax_number": "530-899-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 E 1ST AVE",
            "address_2": "STE C",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261542",
            "telephone_number": "530-899-7300",
            "fax_number": "530-899-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G32061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G320610",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD #",
            "identifier": "930124387",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Ray Licon Jr., NURSE PRACTITIONER
• Pallavi Lidder, LVN
• Lift Assist Inc
• Lift Assist, LLC
• Alexander J Light
• Lim-Saunders-DDS Inc
• Christopher M. Lim
• David Lim, DMD
• Edward Louie Lim, O.D.
• Michael James Lim, DDS

• Family Medicine Physician in Chico, CA
• Providers in Chico, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.