Pacific Grove Family Medicine, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PACIFIC GROVE FAMILY MEDICINE, INC.

Practice address

621 Forest Ave
Pacific Grove, CA 93950-4264

Phone

(831) 649-1011

Fax

(831) 373-8201

NPI assigned

Jul 13, 2012

Last updated

Jul 13, 2012By 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. Eliot Stuart Light, M.D.NPI 1942382577

Title

President

Phone

(831) 649-1011

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 6

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.

• Eliot S Light, MD

  • Family Medicine Physician
  • Pacific Grove, CA
  • NPI 1942382577
  Medicare reassignment Care Compare group NPD Authorized official
• Siang L. Lo, DO

  • Family Medicine Physician
  • Pacific Grove, CA
  • NPI 1821146606
  Medicare reassignment Care Compare group NPD
• David Anthony Anzaldua, M.D.

  • Family Medicine Physician
  • Santa Clara, CA
  • NPI 1699822346
  NPD (past)
• Aaron Jason Cleveland, M.D.

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1497829147
  NPD (past)
• Jane Ann Gingerich, L,C.S.W.

  • Clinical Social Worker
  • Pacific Grove, CA
  • NPI 1174680763
  NPD (past)
• Daniel Stuart Robbins, PHD

  • Clinical Psychologist
  • Pacific Grove, CA
  • NPI 1730262189
  NPD (past)

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1710232996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 FOREST AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939504264",
            "telephone_number": "831-649-1011",
            "fax_number": "831-373-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 FOREST AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939504264",
            "telephone_number": "831-649-1011",
            "fax_number": "831-373-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC GROVE FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "ELIOT",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-649-1011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• One Door Psychology, Inc
• Open Heart Therapy
• P.G.H.C.C., Inc (Pacific Grove Convalescent Hospital)
• Pacific Grove Acupuncture
• Pacific Grove Acupuncture, Inc.
• Pacific Grove Hyperbaric Chamber
• Pacific Grove Medical Clinic, Inc
• Pacific Grove Unified School District
• Anthony Michael Payan, D.C.
• David Peasley

• Family Medicine Physician in Pacific Grove, CA
• Providers in Pacific Grove, 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 Jul 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.