Provider Demographics
NPI:1306927371
Name:CUENCA, ARNOLD (DO)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:CUENCA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23512 MADERO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2743
Mailing Address - Country:US
Mailing Address - Phone:949-583-1600
Mailing Address - Fax:
Practice Address - Street 1:23512 MADERO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-583-1600
Practice Address - Fax:949-454-8067
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9391207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FHC70394FOtherMEDI CAL
W5740BMedicare ID - Type Unspecified