RICHARD ALFONSO LICON

SANTA ANA, CA
NPI1740428101
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA11666)
Enumeration Date2009-01-23
Last Update Date2023-04-25
Business Address
RICHARD ALFONSO LICON PA-C
1401 W 1ST ST STE 101
SANTA ANA, CA 92703-3757
Phone number: 714-542-9700
Mailing Address
RICHARD ALFONSO LICON PA-C
11 TECHNOLOGY DR
IRVINE, CA 92618-2302
Phone number: 949-923-3250
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