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NPI Code Detail

MEDICARE: NURIT LICHT M.D.

MEDICARE: NURIT LICHT M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA90977CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ18742ZOTHERCAISSUER MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2A90977OTHERCALICENSE NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477545176
Entity Type Code : Individual
Provider Name (Legal Business Name) : NURIT LICHT M.D.
Provider Business Mailing Address
First Line : 75 ROWLAND WAY STE 200
Second Line :
City : NOVATO
State : CA
Zip : 94945-5054
Country : US
Telephone Number : 415-897-9664
Fax Number : 415-897-2446
Provider Business Practice Location Address
First Line : 75 ROWLAND WAY STE 200
Second Line :
City : NOVATO
State : CA
Zip : 94945-5054
Country : US
Telephone Number : 415-897-9664
Fax Number : 415-897-2446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 12/09/2025

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Directions to “ NURIT LICHT M.D.” Practice Location

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