Healthcare Provider Details
I. General information
NPI: 1215890827
Provider Name (Legal Business Name): CAVALRY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1250 COAST VILLAGE RD STE L
MONTECITO CA
93108-2720
US
IV. Provider business mailing address
1250 COAST VILLAGE RD STE L
MONTECITO CA
93108-2720
US
V. Phone/Fax
- Phone: 617-686-5614
- Fax:
- Phone: 617-686-5614
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
OREL
SWENSON
Title or Position: CEO
Credential: MD
Phone: 607-743-4973