Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A161848 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A161848 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MT215236 | PA |
NPI | 1184966483 |
---|---|
Provider Name | Ishaan Swarup |
First Address | Oakland, CA 94609-1809 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 14/08/2019 |