Provider Demographics
NPI:1043401375
Name:LAQUI, CECIL CAGUIOA (MD)
Entity Type:Individual
Prefix:DR
First Name:CECIL
Middle Name:CAGUIOA
Last Name:LAQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3679
Mailing Address - Country:US
Mailing Address - Phone:909-948-2859
Mailing Address - Fax:909-919-7730
Practice Address - Street 1:9950 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3679
Practice Address - Country:US
Practice Address - Phone:909-948-2859
Practice Address - Fax:909-919-7730
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA411421Medicare PIN