Individual
DR. ERNESTO LICON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 880-2911
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-2986
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A160205
CA
Other
Enumeration date
06/06/2017
Last updated
03/07/2023
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