Healthcare Provider Details

I. General information

NPI: 1356553945
Provider Name (Legal Business Name): LIELANIE MAE LIONG AGUILAR-PASCASIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

IV. Provider business mailing address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

V. Phone/Fax

Practice location:
  • Phone: 442-265-1525
  • Fax:
Mailing address:
  • Phone: 442-265-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number191567
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME 104714
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD433186
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: