Healthcare Provider Details

I. General information

NPI: 1427976828
Provider Name (Legal Business Name): CHARLES SWIFT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3757 ELLIES ALLIE
PLACERVILLE CA
95667-6210
US

IV. Provider business mailing address

3757 ELLIES ALLIE
PLACERVILLE CA
95667-6210
US

V. Phone/Fax

Practice location:
  • Phone: 530-919-7752
  • Fax:
Mailing address:
  • Phone: 530-919-7752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC37079
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: