Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E4348 | CA |
NPI | 1073516498 |
---|---|
Provider Name | John F Swaim |
First Address | Red Bluff, CA 96080-4327 |
Second Address | Red Bluff, CA 96080-4327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 16/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U85745 | (02) | CA |