Licata, Vincent D

Licata, Vincent D is an individual health care provider with primary practice located at 3133 Professional Dr #20, Auburn CA 95603-2463. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Licata, Vincent D can be contacted via phone (530) 885-8821.

Contact Information

Primary practice address
3133 Professional Dr #20 Auburn CA 95603-2463
Fax: (530) 885-6554
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G49090 California

Profile Details

NPI number 1801946249
LBN Legal business name Licata, Vincent D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2007
Last updated Jul 27th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801946249 NPPES
California MEDICAID 00G490900

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