Licorish Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LICORISH MEDICAL CORPORATION

Practice address

8803 Garden Grove Blvd
Garden Grove, CA 92844-1211

Phone

(714) 523-3154

Fax

(714) 523-4970

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Kenrick Anthony Licorish, M.D.

Title

Ceo

Phone

(714) 523-3154

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942359823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8803 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441211",
            "telephone_number": "714-523-3154",
            "fax_number": "714-523-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441211",
            "telephone_number": "714-523-3154",
            "fax_number": "714-523-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICORISH MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LICORISH",
        "authorized_official_first_name": "KENRICK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-523-3154",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yilinda Li
• Anna Liang
• Megan Liang
• Janette Iraiz Licon
• Yadira Licona
• Sharon Liekhus, P.A
• Lien Thi Khong (Manna Pharmacy)
• Phuong Tatyana Minh Lien
• John Michael Lies, DDS
• Lifang Mao MD Inc

• Internal Medicine Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.