Individual
DR. DANNY LEROY LICKNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 CASA STREET, SUITE 220, SAN LUIS OBISPO, CA 93405-1890
(805) 786-4111
(805) 543-6357
Mailing address
117 WEST BUNNY AVENUE, SANTA MARIA, CA 93458-2805
(805) 786-4111
(805) 543-6357
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G44986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G449860
—
CA
01
—
CB221890
MEDICARE ID
CA
05
—
GR0092202
—
CA
Enumeration date
07/20/2006
Last updated
10/23/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us