Healthcare Provider Details

I. General information

NPI: 1598401044
Provider Name (Legal Business Name): ERIC MARTIN SWANSON MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 BROADWAY ST
REDWOOD CITY CA
94063-3132
US

IV. Provider business mailing address

450 BROADWAY ST MC6343
REDWOOD CITY CA
94063-3132
US

V. Phone/Fax

Practice location:
  • Phone: 650-207-2172
  • Fax:
Mailing address:
  • Phone: 650-721-7212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberV0885
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDR.0075373
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA210766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: