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Jesus L. Licuanan, M.d. Inc
Specialist in Buena Park, California
NPI 1497913057

Jesus L. Licuanan, M.d. Inc is a Specialist based in Buena Park, CA. Jesus L. Licuanan, M.d. Inc practices in Buena Park, CA. The NPI Number for Jesus L. Licuanan, M.d. Inc is 1497913057 and holds a License No. A42300 (California).

The current practice location address for Jesus L. Licuanan, M.d. Inc 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
institution
Provider Profile Details
NPI Number
1497913057
Provider Name
Jesus L. Licuanan, M.d. Inc
Credential
Provider Entity Type
Organization
Address
6131 Orangethorpe Ave, Buena Park, CA, 90620-1315
Phone Number
714-521-1700
Fax Number
714-521-1003
Provider Enumeration Date
05/29/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AQ154 01 CA P-TAN
00A423000 01 CA BLUE SHIELD OF CALIFORNIA
A42300 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.
A42300 (California)
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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