| Dr Johnson Benjamin Lightfoote, MD | |
|
1798 N Garey Ave, Pomona, CA 91767 | |
| (909) 865-9535 | |
| (909) 630-7394 |
| Full Name | Dr Johnson Benjamin Lightfoote |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 49 Years |
| Location | 1798 N Garey Ave, Pomona, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083696637 | NPI | - | NPPES |
| ME 90724 | Other | FL | STATE MEDICAL LICENSE |
| 200500078 | Other | NC | STATE MEDICAL LICENSE |
| G39456 | Other | CA | STATE MEDICAL LICENSE |
| AL 8043 | Other | AL | STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085N0700X | Radiology - Neuroradiology | G39456 (California) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | G39456 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Pomona Valley Hospital Medical Center | Pomona, CA | Hospital |
| Eisenhower Medical Center | Rancho mirage, CA | Hospital |
| San Antonio Regional Hospital | Upland, CA | Hospital |
| Emanate Health Inter-community Hospital | Covina, CA | Hospital |
| Casa Colina Hospital | Pomona, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Palm Desert Radiology Medical Group Inc | 0749173789 | 121 |
| Pomona Valley Imaging Medical Group Inc | 6709898562 | 10 |
| Entity Name | Palm Desert Radiology Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124079868 PECOS PAC ID: 0749173789 Enrollment ID: O20040204000599 |
| Entity Name | Pomona Valley Imaging Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982667911 PECOS PAC ID: 6709898562 Enrollment ID: O20060615000324 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Johnson Benjamin Lightfoote, MD 808 S Easthills Dr, West Covina, CA 91791-3449 Ph: (909) 865-9535 | Dr Johnson Benjamin Lightfoote, MD 1798 N Garey Ave, Pomona, CA 91767 Ph: (909) 865-9535 |
Hrayr A Kabakian, MD Radiology Medicare: Medicare Enrolled Practice Location: 1798 N Garey Ave, Pomona, CA 91767 Phone: 909-865-9500 | |
Dr. Monish Jatin Laxpati, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2475 N Garey Ave, Pomona, CA 91767 Phone: 909-622-3166 Fax: 909-622-8046 | |
Dr. James Philip Warren, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1902 Royalty Dr, Pomona, CA 91767 Phone: 714-573-7647 | |
Christina Tsao Benedict, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1798 N Garey Ave, Pomona, CA 91767 Phone: 909-865-9535 Fax: 909-397-0194 | |
Alexander J Chien, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1798 N Garey Ave, Pomona, CA 91767 Phone: 909-865-9500 | |
Dr. Bernie Robert Goler, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1902 Royalty Dr, Suite 220, Pomona, CA 91767 Phone: 909-620-8180 Fax: 909-469-6741 |