Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. WADE K.C. LICUP, MD
Active Sole ProprietorDR. WADE K.C. LICUP, MD is a Family Medicine healthcare provider located in VISTA, California. NPI 1881157998 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · VISTA, CA
Registration Details
- NPI Number
- 1881157998
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 8, 2019 (7.1696645381943 yrs)
- Last Updated
- Apr 28, 2023
- License
-
A179911 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
130 CEDAR RDVISTA, CA, 920835102Browse CA providers · Browse ZIP 92083
- Phone
- 7608065500
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in VISTA, CA
| Name | Credential | NPI |
|---|---|---|
| SILVIA PACHECO MENDOZA | PHYSICIAN ASSISTANT | 1245232404 |
| DR. CHRISTOPHER PUDOL | D.O. | 1851386080 |
| DR. RYAN M. HIKES | MD | 1609862358 |
| MELISSA E. HURD | M.D. | 1487643698 |
| DR. MARK S. BIBLER | M.D. | 1427048487 |
| MARY C. CUEVA | M.D. | 1023008083 |
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.