Individual
DR. DAVID V LIGHTFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
720 4TH ST, SANTA ROSA, CA 95404-4421
(707) 575-3800
(707) 528-4967
Mailing address
720 4TH ST, SANTA ROSA, CA 95404-4421
(707) 575-3800
(707) 528-4967
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G57122
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G571220
—
CA
01
—
180009845
RAILROAD MEDICARE
CA
01
—
B003
CHAMPUS
CA
Enumeration date
10/21/2005
Last updated
07/01/2008
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