PACIFIC GROVE FAMILY MEDICINE, INC. NPI 1710232996

Family Medicine in Pacific Grove, CA

NPI 1710232996 Organization Family Medicine CLIA Number 05D0975501 CLIA Certificate of Waiver

About PACIFIC GROVE FAMILY MEDICINE, INC.

Pacific Grove Family Medicine, Inc. is a primary care provider established in Pacific Grove, California specializing in family medicine. The NPI number of Pacific Grove Family Medicine, Inc. is 1710232996 and was assigned on July 2012. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. Pacific Grove Family Medicine, Inc. operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Eliot Stuart Light M.d. (President)

A primary care provider (PCP) like Pacific Grove Family Medicine, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Pacific Grove Family Medicine, Inc. is 05D0975501 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Pacific Grove Family Medicine, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1710232996

Provider NamePACIFIC GROVE FAMILY MEDICINE, INC.
Provider Location Address621 FOREST AVE PACIFIC GROVE, CA 93950
Provider Mailing Address621 FOREST AVE PACIFIC GROVE, CA 93950
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-13-2012
Last Update Date07-13-2012


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

PACIFIC GROVE FAMILY MEDICINE, INC.
621 FOREST AVE
PACIFIC GROVE, CA
ZIP 93950
Phone: (831) 649-1011
Fax: (831) 373-8201

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Mailing Address

PACIFIC GROVE FAMILY MEDICINE, INC.
621 FOREST AVE
PACIFIC GROVE, CA
ZIP 93950
Phone: (831) 649-1011
Fax: (831) 373-8201



Authorized Official

Authorized Official NameDR. ELIOT STUART LIGHT M.D.
Authorized Official TitlePRESIDENT
Authorized Official Phone(831) 649-1011

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1710232996 is:

CLIA Number05D0975501
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Other Providers at the same location


The following 15 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1528084456 JAMES S MORAN PH.D.
Individual
Clinical Neuropsychologist621 FOREST AVE STE 2C
PACIFIC GROVE, CA 93950
(831) 373-1499
1881614626DR. BILL ZIKA PH.D.
Individual
Psychologist (Clinical)621 FOREST AVE SUITE 3
PACIFIC GROVE, CA 93950
(831) 595-0410
1528082344MS. BARRIE ELIZABETH O'BRIEN MFT
Individual
Marriage & Family Therapist621 FOREST AVE STE. 3-B
PACIFIC GROVE, CA 93950
(831) 646-8042
1508966193MS. EILEEN NAZZARO MFT
Individual
Marriage & Family Therapist621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 643-1736
1730262189DR. DANIEL STUART ROBBINS PHD
Individual
Psychologist (Clinical)621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 372-2900
1174680763MS. JANE ANN GINGERICH L,C.S.W.
Individual
Social Worker (Clinical)621 FOREST AVE SUITE 3-D
PACIFIC GROVE, CA 93950
(831) 373-5123
1760510127 HEATHER L CRIMSON MFT
Individual
Marriage & Family Therapist621 FOREST AVE SUITE 4C
PACIFIC GROVE, CA 93950
(831) 236-8518
1588789424MRS. JULIE KATHLEEN MCCLUNG M.F.T.
Individual
Marriage & Family Therapist621 FOREST AVE SUITE 3B
PACIFIC GROVE, CA 93950
(831) 649-0199
1710194667 LYNNE CONLON
Individual
Psychologist (Clinical)621 FOREST AVE SUITE 3
PACIFIC GROVE, CA 93950
(831) 647-0805
1588868012DR. NICOLE ASSELBORN M.D.
Individual
Psychiatry & Neurology (Psychiatry)621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 642-9878
1386828432DR. MARTHA ELIZABETH GLEASON PHD
Individual
Psychologist621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 375-0728
1891960712 ERIN ANNE GOLEC PA
Individual
Physician Assistant621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 649-1011
1548381569 ANDREA FULLER MFT
Individual
Marriage & Family Therapist621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 236-5930
1942382577DR. ELIOT S LIGHT MD
Individual
Family Medicine621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 649-1011
1821146606 SIANG L. LO DO
Individual
Family Medicine621 FOREST AVE
PACIFIC GROVE, CA 93950
(831) 649-1011

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.