Provider Demographics
NPI:1699544569
Name:LIGHTYEAR HEALTH CLINIC VA, INC.
Entity type:Organization
Organization Name:LIGHTYEAR HEALTH CLINIC VA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAIBHAV
Authorized Official - Middle Name:
Authorized Official - Last Name:RIKHYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-270-0908
Mailing Address - Street 1:2950 BUSKIRK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-6900
Mailing Address - Country:US
Mailing Address - Phone:888-380-0988
Mailing Address - Fax:
Practice Address - Street 1:919 E MAIN ST STE 1000
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-4623
Practice Address - Country:US
Practice Address - Phone:888-390-0988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty