Paul J. Licata Md Inc.
LBN: Paul J. Licata Md Inc.
Paul J. Licata Md Inc. is an health care organization with primary practice located at 3356 W Ball Rd Suite 206, Anaheim CA 92804-3702. The organization recently has 2 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty.
Paul J. Licata Md Inc. can be contacted via phone (714) 827-8890, or through Licata, Paul James via phone (714) 827-8890.
Contact Information
Primary practice address
3356 W Ball Rd Suite 206
Anaheim CA 92804-3702
Phone: (714) 827-8890
Fax: (714) 827-8905
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / General Practice | 163WG0000X | A25662 | California |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | A25662 | California |
Profile Details
| NPI number | 1407096720 |
|---|---|
| LBN Legal business name | Paul J. Licata Md Inc. |
| DBA Doing business as | |
| Authorized official | Licata, Paul James Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 26th, 2009 |
| Last updated | Apr 15th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407096720 | NPPES |
| Other | BS00A256626 | BLUE SHIELD | |
| MEDICAID | 00A25662 | BLUE SHIELD |
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