Healthcare Provider Details

I. General information

NPI: 1538285754
Provider Name (Legal Business Name): MEENAL SWAMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15525 POMERADO ROAD SUITE B-1
POWAY CA
92064-2435
US

IV. Provider business mailing address

15525 POMERADO RD SUITE B-1
POWAY CA
92064-2435
US

V. Phone/Fax

Practice location:
  • Phone: 858-487-8333
  • Fax: 858-487-0856
Mailing address:
  • Phone: 858-487-8333
  • Fax: 858-487-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA100061
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLL1469
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: