Healthcare Provider Details

I. General information

NPI: 1518875566
Provider Name (Legal Business Name): NINA SWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S ALVARADO ST
LOS ANGELES CA
90006-4100
US

IV. Provider business mailing address

1135 S ALVARADO ST
LOS ANGELES CA
90006-4100
US

V. Phone/Fax

Practice location:
  • Phone: 213-381-8500
  • Fax:
Mailing address:
  • Phone: 213-381-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number756019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: