Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | G38850 | CA |
NPI | 1962514125 |
---|---|
Provider Name | Dr. Thomas Andrew Schweller |
First Address | Solana Beach, CA 92075-1557 |
Second Address | San Diego, CA 92103-5716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 29/06/2010 |