Licuanan, Jesse Joseph
Licuanan, Jesse Joseph is an sole proprietor health care provider with primary practice located at 3650 South St Ste 403 , Lakewood CA 90712-1504. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Licuanan, Jesse Joseph can be contacted via phone (562) 531-0377.Contact Information
Primary practice address
3650 South St Ste 403
Lakewood CA 90712-1504
Phone: (562) 531-0377
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | A-87633 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A87633 | California |
Profile Details
| NPI number | 1396795514 |
|---|---|
| LBN Legal business name | Licuanan, Jesse Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2006 |
| Last updated | Jan 6th, 2023 - about last year |
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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