Individual
KENNETH IAN LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 CALIFORNIA ST, SUITE 340, SAN FRANCISCO, CA 94109-4586
(415) 673-4500
Mailing address
13847 E 14TH ST STE 118, SAN LEANDRO, CA 94578-2625
(415) 673-4500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G35263
—
Other
Enumeration date
10/25/2006
Last updated
07/19/2022
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