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General NPI Number Information
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NPI Number | 1568048411
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Entity Type | Individual
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Provider Name | JEREMY RYAN SWISHER MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 7230 MEDICAL CENTER DR STE 604
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City | WEST HILLS
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State | CA
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Zip | 91307-4021
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Country | US
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Telephone | 310-319-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2022-02789
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | A196735
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License Number State | CA
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