Individual
MR. RICO LIWANAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA, MSN
Contact information
Practice address
4940 EASTERN AVE RM 588, BALTIMORE, MD 21224-2735
(410) 550-0942
Mailing address
3460 E LA PALMA AVE, ANAHEIM, CA 92806-2020
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R160556
MD
Other
Enumeration date
10/31/2016
Last updated
06/02/2022
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