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Jesus Lomibao Licuanan, MD
Specialist in Buena Park, California
NPI 1306897780

Jesus Lomibao Licuanan is a Specialist based in Buena Park, CA. Jesus Lomibao Licuanan practices in Buena Park, CA and has the professional credentials of MD. The NPI Number for Jesus Lomibao Licuanan is 1306897780 and holds a License No. (California).

The current practice location address for Jesus Lomibao Licuanan is 6131 Orangethorpe Ave, Buena Park, CA and can be reached out via phone at 714-521-1700 and via fax at 714-521-1003.

Location: 6131 Orangethorpe Ave, Buena Park, CA, 90620-1315
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306897780
Provider Name
Jesus Lomibao Licuanan
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6131 Orangethorpe Ave, Buena Park, CA, 90620-1315
Phone Number
714-521-1700
Fax Number
714-521-1003
Provider Enumeration Date
05/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A423000 05 CA
institution
Provider Business Practice Location Address Details
Address
6131 Orangethorpe Ave
City
Buena Park
State
California
Zip
90620-1315
Phone Number
714-521-1700
Fax Number
714-521-1003
person
Provider Business Mailing Address Details
Address
6131 Orangethorpe Ave
City
Buena Park
State
California
Zip
90620-1315
Phone Number
714-521-1700
Fax Number
714-521-1003
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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