Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | C39805 | CA |
NPI | 1013912054 |
---|---|
Provider Name | Richard Eric Swensson |
First Address | Costa Mesa, CA 92626-7341 |
Second Address | Long Beach, CA 90806-1737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 08/07/2007 |