Healthcare Provider Details

I. General information

NPI: 1831400795
Provider Name (Legal Business Name): STRONGKIDS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 10/09/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S MAIN ST
SANTA ANA CA
92707-3220
US

IV. Provider business mailing address

PO BOX 8500
NEWPORT BEACH CA
92658-8500
US

V. Phone/Fax

Practice location:
  • Phone: 714-542-1331
  • Fax: 714-542-4758
Mailing address:
  • Phone: 714-542-1331
  • Fax: 714-542-4758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA44664
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA35731
License Number StateCO

VIII. Authorized Official

Name: DR. JACOB SWEIDAN
Title or Position: PRESIDENT/CEO/OWNER
Credential: M.D.
Phone: 714-915-4656