Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A9391 | CA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 20A9391 | CA |
NPI | 1306927371 |
---|---|
Provider Name | Dr. Arnold Cuenca |
First Address | Mission Viejo, CA 92691-2743 |
Second Address | Mission Viejo, CA 92691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 17/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FHC70394F | MEDI CAL (01) |