MEDICARE: DR. SWATI PATHAK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	269843	NY
2	207R00000X	Internal Medicine Physician	C160212	CA

General Provider Information

NPI Number	:	1033409644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SWATI PATHAK M.D.

Provider Business Mailing Address
First Line	:	10470 OLD PLACERVILLE RD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2539
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 SAINT DOMINICS DR STE 201
Second Line	:
City	:	MANTECA
State	:	CA
Zip	:	95337-7802
Country	:	US
Telephone Number	:	209-823-2347
Fax Number	:	209-823-1408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2011
Last Update Date	:	02/08/2019

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Directions to “ DR. SWATI PATHAK M.D.” Practice Location

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