Organization
PAUL JOHN LICATA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JOHN LICATA M.D. (OWNER)
(949) 448-9728
Entity
Organization
Contact information
Practice address
25431 CABOT RD, STE 115, LAGUNA HILLS, CA 92653-5518
(949) 448-9728
(949) 448-9732
Mailing address
25431 CABOT RD, STE 115, LAGUNA HILLS, CA 92653-5518
(949) 448-9728
(949) 448-9732
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A25662CA
CA
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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