Eliza Kym Liwanag

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95031075 Issued in CA

Practice address

11262 Campus St
Loma Linda, CA 92350-1727

Phone

(909) 558-1000

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vituity Healthcare Services PCGroup PAC ID 2668812710, 27 clinicians

Vituity Physician Services PCGroup PAC ID 0749620888, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vituity Healthcare Services PC

  • Family Medicine Physician
  • Colton, CA
  • NPI 1700642758
  Medicare reassignment Care Compare group NPD
• Vituity Physician Services PC

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1124884176
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1245935915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501727",
            "telephone_number": "909-558-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501727",
            "telephone_number": "909-558-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIWANAG",
        "first_name": "ELIZA KYM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95031075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy P. Liu, M.D.
• Taryn Rose Liu, DO, MPH, MS
• William Liu, DPM
• Yuan Liu, MD
• Gabrielle Liudahl
• Veronica C Llamas, PHD
• Lluh Education Consortium
• Llumc Transplant Institute
• Llusd Special Care Dentistry
• Jennifer Lo, M.D.

• Nurse Practitioner in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.