Individual
REGINA LAICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 499-6440
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A124296
CA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
A124296
CA
Other
Enumeration date
04/22/2011
Last updated
02/02/2021
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