Edsil Banduyang Liwag

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

370804527 Issued in CA

Practice address

3993 Caseman Ave
San Diego, CA 92154-2508

Phone

(619) 690-1022

NPI assigned

Sep 25, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Edsil Banduyang Liwag Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1952180580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3993 CASEMAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921542508",
            "telephone_number": "619-690-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3993 CASEMAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921542508",
            "telephone_number": "619-690-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIWAG",
        "first_name": "EDSIL",
        "middle_name": "BANDUYANG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "6002863740",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "370804527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDSIL",
            "last_name": "LIWAG",
            "middle_name": "BANDUYANG",
            "credential": "ADMINISTRATOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cheyenne Autumn Livingston
• Hannah Livingston
• Tamara Livingston, M.A.
• Theresa Cherie Livingston
• Brian Patrick Livingstone, A.T.,C.
• Jazmyn Angel Liwag, BA
• Nora Liwag
• Cherry Pandongit Liwan
• Jazzel Liwanag
• Melissa Liwanag, PA-C

• Home Health Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.