Healthcare Provider Details

I. General information

NPI: 1528554656
Provider Name (Legal Business Name): HIREN SWAMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2018
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6633 TELEPHONE RD STE 212
VENTURA CA
93003-5569
US

IV. Provider business mailing address

5767 W CENTURY BLVD SUITE 400
LOS ANGELES CA
90095-5631
US

V. Phone/Fax

Practice location:
  • Phone: 805-644-9121
  • Fax: 805-644-9131
Mailing address:
  • Phone: 310-301-8707
  • Fax: 310-301-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA173388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: