Healthcare Provider Details

I. General information

NPI: 1548246770
Provider Name (Legal Business Name): AVRIL SWAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1286 SANCHEZ ST
SAN FRANCISCO CA
94114-3833
US

IV. Provider business mailing address

1286 SANCHEZ ST
SAN FRANCISCO CA
94114-3833
US

V. Phone/Fax

Practice location:
  • Phone: 415-642-0333
  • Fax: 415-642-6233
Mailing address:
  • Phone: 415-642-0333
  • Fax: 415-642-6233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA76538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: