Aventura, Caroline Marie Licud

Aventura, Caroline Marie Licud is an individual health care provider with primary practice located at 1300 S Sunset Ave , West Covina CA 91790-3342. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Aventura, Caroline Marie Licud can be contacted via phone (626) 338-9915.

Contact Information

Primary practice address
1300 S Sunset Ave West Covina CA 91790-3342
Phone: (626) 338-9915
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301084039 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A102553 California

Profile Details

NPI number 1962623538
LBN Legal business name Aventura, Caroline Marie Licud
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2007
Last updated Jul 24th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962623538 NPPES
California Other W14158 SITE PTAN
California Other ZZZ20041Z SITE PTAN

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