South County Medical
NPI 1467697276ActiveOrganization· Physician Assistant· Trabuco Canyon, CA
Physician Assistant in Trabuco Canyon, California, registered in NPPES in December 2008. The authorized official on file is Richard Licon, PA-C, Ceo/President.
Overview
| NPI | 1467697276 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 8, 2008 |
| Last updated in NPPES | Nov 14, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA11666 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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