NPI Code Detail JSON Logo

1003806233 NPI number — BRENDA J SWIDERSKI O.D.

NPI Number: 1003806233
Health Care Provider/Practitioner: BRENDA J SWIDERSKI O.D.

Information about “1003806233” NPI (BRENDA J SWIDERSKI O.D.) exists in 1003806233 in HTML format HTML  |  1003806233 in plain Text format TXT  |  1003806233 in PDF (Portable Document Format) PDF  |  1003806233 in an XML format XML  formats.

NPI Number : 1003806233 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003806233",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SWIDERSKI",
    "FirstName": "BRENDA",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ANDERSEN",
    "OtherFirstName": "BRENDA",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "OD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "8080 PARKWAY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LA MESA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91942-2104",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "619-589-7500",
    "MailingAddressFaxNumber": "619-589-7500",
    "FirstLinePracticeLocationAddress": "6945 EL CAJON BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92115-1754",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "619-697-4600",
    "PracticeLocationAddressFaxNumber": "619-464-5526",
    "EnumerationDate": "10/27/2005",
    "LastUpdateDate": "12/23/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "OPT12109",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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