Healthcare Provider Details

I. General information

NPI: 1679003180
Provider Name (Legal Business Name): JEFFREY A SWARZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2017
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8723 ALDEN DR STE 240
LOS ANGELES CA
90048-3692
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-7779
  • Fax: 310-423-8269
Mailing address:
  • Phone: 310-423-7779
  • Fax: 310-423-8269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number272711
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA178127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: