Provider Demographics
NPI:1437122082
Name:ASUNCION, LIWANAG (MD)
Entity Type:Individual
Prefix:
First Name:LIWANAG
Middle Name:
Last Name:ASUNCION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 E BERMUDA DUNES ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-6717
Mailing Address - Country:US
Mailing Address - Phone:440-225-7095
Mailing Address - Fax:440-988-5269
Practice Address - Street 1:606 E BERMUDA DUNES ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-6717
Practice Address - Country:US
Practice Address - Phone:440-225-7095
Practice Address - Fax:909-295-9100
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC158496207R00000X
OH35034771207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000129195OtherANTHEM
OH0204817Medicaid
E85296OtherSUMMA
350188OtherWELLCARE OF OH
350189OtherWELLCARE OF OH
OH3025372Medicaid
393531708Medicare PIN
OH3025372Medicaid
0391723Medicare PIN
E85296OtherSUMMA
OH9389631Medicare PIN