Healthcare Provider Details

I. General information

NPI: 1841592763
Provider Name (Legal Business Name): SWAPNA BUSA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 12/08/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S PIERCE ST
EL CAJON CA
92020-4124
US

IV. Provider business mailing address

PO BOX 511491
LOS ANGELES CA
90051-8046
US

V. Phone/Fax

Practice location:
  • Phone: 619-334-4869
  • Fax: 619-334-4940
Mailing address:
  • Phone: 866-284-2771
  • Fax: 800-334-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA61769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: