MEDICARE: JEFFREY WINHAM SWENSON 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	207P00000X	Emergency Medicine Physician	G57266	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881605913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY WINHAM SWENSON M.D.

Provider Business Mailing Address
First Line	:	1531 ESPLANADE
Second Line	:	ATTN: FINANCE
City	:	CHICO
State	:	CA
Zip	:	95926-3310
Country	:	US
Telephone Number	:	530-332-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	888 LAKESIDE VLG COMMONS
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-3979
Country	:	US
Telephone Number	:	530-332-6850
Fax Number	:	530-893-6857

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	11/05/2014

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