JESUS L. LICUANAN, M.D. INC
NPI 1497913057
Specialist in Buena Park, CA

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

Active since May 29, 2008

6131 ORANGETHORPE AVE, # 215, BUENA PARK, CA 90620(714) 521-1700(714) 521-1003 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jesus L. Licuanan, M.d. Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESUS L. LICUANAN, M.D. INC (NPI 1497913057) is a healthcare organization registered as a specialist in Buena Park, California and active in the NPI registry since May 2008. The organization lists Jesus L Licuanan, President/owner, as its authorized official.

NPPES Registry Identity

NPI1497913057

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameJESUS L. LICUANAN, M.D. INC

Location Address6131 ORANGETHORPE AVE, # 215Buena Park, CA 90620-1315

Mailing Address6131 Orangethorpe Ave, # 215Buena Park, CA 90620-1315 · (714) 521-1700 · Fax (714) 521-1003

Phone(714) 521-1700

Fax(714) 521-1003

Organization SubpartNo

Authorized OfficialJesus L LicuananPresident/owner · (714) 521-1700

Enumeration DateMay 29, 2008

Last NPPES UpdateMarch 7, 2023

✔ NPI 1497913057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · A42300

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.

6131 ORANGETHORPE AVE, Buena Park, CA 90620

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Other Identifiers 3

OtherAQ154CA · P-tan

Other00A423000CA · Blue Shield Of California

MedicaidA42300CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP