Jesus L. Licuanan, M.d. INC
NPI #1497913057 in Buena Park, California
Provider Information
- NPI Number
- 1497913057
- Entity Type
- Organization
- Organization Name
- Jesus L. Licuanan, M.d. INC
- Primary Specialty
- Specialist
- Enumeration Date
- May 29, 2008
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 6131 ORANGETHORPE AVE
- Address 2
- # 215
- City
- Buena Park
- State
- California
- ZIP Code
- 90620-1315
- Phone
- (714) 521-1700
Authorized Official
- Name
- DR. JESUS L LICUANAN, M.D.
- Title
- PRESIDENT/OWNER
- Phone
- (714) 521-1700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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