Healthcare Provider Details

I. General information

NPI: 1144374224
Provider Name (Legal Business Name): SWIFT'S CRITICAL CARE NETWORK FOR CHILDREN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 SAMARITAN DR
SAN JOSE CA
95124-3908
US

IV. Provider business mailing address

3006 S MARYLAND PKWY 505
LAS VEGAS NV
89109-2218
US

V. Phone/Fax

Practice location:
  • Phone: 888-350-2911
  • Fax: 702-369-5827
Mailing address:
  • Phone: 888-350-2911
  • Fax: 702-369-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES SWIFT
Title or Position: PRESIDENT
Credential: MD
Phone: 888-350-2911