Organization
AMNON LICHT MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMNON LICHT M.D. (PRESIDENT)
(310) 839-3200
Entity
Organization
Contact information
Practice address
9808 VENICE BLVD, SUITE 706, CULVER CITY, CA 90232-2732
(310) 839-3200
(310) 839-1247
Mailing address
9808 VENICE BLVD, SUITE 706, CULVER CITY, CA 90232-2732
(310) 839-3200
(310) 839-1247
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A32682
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A326820
MEDI-CAL
CA
Enumeration date
02/18/2010
Last updated
02/18/2010
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