Paul John Licata MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A25662CA Issued in CA

Legal business name

PAUL JOHN LICATA MD

Practice address

25431 Cabot Rd
Ste 115
Laguna Hills, CA 92653-5518

Phone

(949) 448-9728

Fax

(949) 448-9732

NPI assigned

Sep 18, 2015

Last updated

Sep 18, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul John Licata, M.D.NPI 1740361518

Title

Owner

Phone

(949) 448-9728

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul John Licata, M.D.

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1740361518
  NPD (past) Authorized official
• Joanne G. Pagal, DO

  • Family Medicine Physician
  • Laguna Hills, CA
  • NPI 1407908866
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1356710438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25431 CABOT RD",
            "address_2": "STE 115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535518",
            "telephone_number": "949-448-9728",
            "fax_number": "949-448-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25431 CABOT RD",
            "address_2": "STE 115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535518",
            "telephone_number": "949-448-9728",
            "fax_number": "949-448-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL JOHN LICATA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "LICATA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-448-9728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A25662CA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patient's Choice Home Health, Inc.
• Patrick Prateep Chaipat
• Shada Marie Patterson, MA
• Kenneth Leon Patton, BA, CADC III
• Kenneth Yurdin Pauker, M.D.
• Alexandra Maude Paulsen, B.A.
• Kate Pavlak, MFT
• Payam C Ataii, DMD, Inc (Laser Dental Center)
• Mehrnaz Paydar
• Christopher Scott Pearson, P.T.

• Primary Care Clinic/Center in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.