Healthcare Provider Details

I. General information

NPI: 1063550515
Provider Name (Legal Business Name): JOHN EDWARD SWARTZBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 UNIVERSITY HALL UNIVERSITY OF CALIFORNIA, BERKELEY
BERKELEY CA
94720-1191
US

IV. Provider business mailing address

570 UNIVERSITY HALL UNIVERSITY OF CALIFORNIA, BERKELEY
BERKELEY CA
94720-1191
US

V. Phone/Fax

Practice location:
  • Phone: 510-643-0499
  • Fax:
Mailing address:
  • Phone: 510-643-0499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA24314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: