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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JESSE JOSEPH LICUANAN, M.D.

Active Sole Proprietor

Internal Medicine · LAKEWOOD, CA

Registration Details

NPI Number
1396795514
Provider Type
Individual
Gender
Male
NPI Issued
May 10, 2006 (19.94965823242 yrs)
Last Updated
Jan 6, 2023
Licenses
A-87633 (CA)
A87633 (CA)
Sole Proprietor
Yes

Practice Information

Address
3650 SOUTH ST STE 403
LAKEWOOD, CA, 907121504
Browse CA providers · Browse ZIP 90712
Phone
5625310377
Primary Specialty
Internal Medicine
207R00000X
Additional Specialty
Internal Medicine

Other Internal Medicine Providers in LAKEWOOD, CA

Name Credential NPI
DR. PRASAD K. CHODE MD 1194720847
DAISY J. GUEVARA MD 1396740932
AUGUSTUS K. OHEMENG MD 1982603890
DR. MICHAEL FREUND M.D. 1447244157
MS. SU HYON YI M.D. 1902867476
OLGA R GINZBURG MD 1891723482
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.