Cucalon, Juan Carlos

Cucalon, Juan Carlos is an sole proprietor health care provider with primary practice located at 1441 Florida Ave , Modesto CA 95350-4404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Cucalon, Juan Carlos can be contacted via phone (209) 214-1211.

Contact Information

Primary practice address
1441 Florida Ave Modesto CA 95350-4404
Phone: (209) 214-1211
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME86152 Florida
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C170661 California

Profile Details

NPI number 1649251083
LBN Legal business name Cucalon, Juan Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2005
Last updated Nov 25th, 2020 - about 5 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 1649251083 NPPES
Florida Other 71471 B/C & B/S OF FL
Florida MEDICAID 266805000 B/C & B/S OF FL

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