Healthcare Provider Details

I. General information

NPI: 1306927371
Provider Name (Legal Business Name): ARNOLD CUENCA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23512 MADERO
MISSION VIEJO CA
92691
US

IV. Provider business mailing address

23512 MADERO
MISSION VIEJO CA
92691-2743
US

V. Phone/Fax

Practice location:
  • Phone: 949-583-1600
  • Fax: 949-454-8067
Mailing address:
  • Phone: 949-583-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A9391
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A9391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: