Maria Marissa De Leon Liwag, MD | |
4125 Bangs Ave, Modesto, CA 95356-8713 | |
(209) 551-3174 | |
(209) 557-1685 |
Full Name | Maria Marissa De Leon Liwag |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 4125 Bangs Ave, Modesto, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467500470 | NPI | - | NPPES |
00A899740 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A89974 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Maria Marissa De Leon Liwag, MD 4125 Bangs Ave, Modesto, CA 95356-8713 Ph: (209) 551-3174 | Maria Marissa De Leon Liwag, MD 4125 Bangs Ave, Modesto, CA 95356-8713 Ph: (209) 551-3174 |
Charnjeet K Randhawa, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4601 Dale Rd, Modesto, CA 95356 Phone: 209-735-5000 Fax: 559-459-4569 | |
Chaithra Sreenath, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 401 Paradise Rd Ste E102, Modesto, CA 95351 Phone: 209-558-4000 | |
Mohamed Ashkar, Pediatrics Medicare: Medicare Enrolled Practice Location: 1510 Florida Ave, Modesto, CA 95350 Phone: 209-722-4842 | |
Lee T Donohue, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-569-7408 | |
Angela I Lin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1144 Coffee Rd, Modesto, CA 95355 Phone: 209-550-4744 | |
Miss Donna Silva, NP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4120 Prescott Rd, Modesto, CA 95356 Phone: 209-544-7300 Fax: 209-544-7323 | |
Dr. Mary Jessie Sumithra, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 4125 Bangs Ave, Modesto, CA 95356 Phone: 209-557-1630 |