Healthcare Provider Details

I. General information

NPI: 1770819187
Provider Name (Legal Business Name): MICHAEL H SWETYE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PARNASSUS AVE BOX 0984
SAN FRANCISCO CA
94143-0984
US

IV. Provider business mailing address

401 PARNASSUS AVE BOX 0984
SAN FRANCISCO CA
94143-0984
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-7799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA 109740
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA 109740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: