Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 8909 | CA |
NPI | 1043367717 |
---|---|
Provider Name | Dr. Janis Miller Lightman |
First Address | Sacramento, CA 95815-4807 |
Second Address | Sacramento, CA 95815-4807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 30/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H776377 | (02) | CA |