Kenneth I Light MD Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

G035263 Issued in CA

Legal business name

KENNETH I LIGHT MD INC

Practice address

1700 California St Ste 340
San Francisco, CA 94109-4589

Phone

(415) 673-4500

NPI assigned

Jun 20, 2008

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth I Light, MDNPI 1104900919

Title

Ceo

Phone

(415) 673-4500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Ian Light, M.D.

  • Specialist
  • San Francisco, CA
  • NPI 1104900919
  Authorized official Same address or phone

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1669633772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CALIFORNIA ST STE 340",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094589",
            "telephone_number": "415-673-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CALIFORNIA ST STE 340",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094589",
            "telephone_number": "415-673-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH I LIGHT MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-673-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G035263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Gabriel Kenney, LMFT# 146923
• Paula Lynn Kenney I, MFT

• Specialist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.