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1114218559
JESSE J LICUANAN MD A MEDICAL CORPORATION
LAKEWOOD, CA
NPI
1114218559
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Entity Type
Organization
Authorized Contact
JESSE J. LICUANAN
President/Owner
562-531-0377
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2011-04-19
Last Update Date
2011-04-19
Business Address
JESSE J LICUANAN MD A MEDICAL CORPORATION
3300 E SOUTH ST SUITE 205
LAKEWOOD, CA 90805-4549
Phone number: 562-531-0377
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Mailing Address
JESSE J LICUANAN MD A MEDICAL CORPORATION
8251 LA PALMA AVE SUITE 434
BUENA PARK, CA 90620-3205
Phone number: 562-531-0377
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