Jonathan Nordlicht MD Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G32963 Issued in CA

Legal business name

JONATHAN NORDLICHT MD MEDICAL CORPORATION

Practice address

3905 Sacramento
Suite 104
San Francisco, CA 94118

Phone

(415) 668-5666

Fax

(415) 668-5866

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Jonathan Frank Nordlicht, MD

Title

President of Corporation

Phone

(415) 668-5666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1609973882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 SACRAMENTO",
            "address_2": "SUITE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94118",
            "telephone_number": "415-668-5666",
            "fax_number": "415-668-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 SACRAMENTO",
            "address_2": "SUITE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94118",
            "telephone_number": "415-668-5666",
            "fax_number": "415-668-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN NORDLICHT MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "NORDLICHT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "415-668-5666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G32963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.