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WADE LICUP, MD
MD
Family Medicine Physician
NPI: 1881157998IndividualAccepts Medicare
Specialties, Licenses & Credentials
Family Medicine PhysicianPrimary
Family Medicine
Code: 207Q00000X
A179911(CA)
CMS Specialties
PrimaryFAMILY PRACTICE
Education
OTHER
Class of 2019
Contact & Hours
Via practice · 3 locations total
- Address
- 4560 ADMIRALTY WAY STE 100
MARINA DEL REY, CA 90292 - Phone
- (310) 827-3700
Quick Facts
- NPI
- 1881157998
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 1
- Locations
- 3
- Years in Practice
- 7
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