Individual provider · Type 1 NPI

Jesus Lomibao Licuanan, MD

Specialist · Buena Park, CA

NPI number 1306897780 Active

Practice location

6131 Orangethorpe Ave, Suite 215
Buena Park, CA 90620-1315

Fax (714) 521-1003

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1306897780

Jesus Lomibao Licuanan, MD's National Provider Identifier is 1306897780, issued on May 12, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Buena Park, CA. The record was last updated on Jul 13, 2026.