Healthcare Provider Details

I. General information

NPI: 1881605913
Provider Name (Legal Business Name): JEFFREY WINHAM SWENSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 LAKESIDE VLG COMMONS
CHICO CA
95928-3979
US

IV. Provider business mailing address

1531 ESPLANADE ATTN: FINANCE
CHICO CA
95926-3310
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-6850
  • Fax: 530-893-6857
Mailing address:
  • Phone: 530-332-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG57266
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: