MEDICARE: SWIFT'S CRITICAL CARE NETWORK FOR CHILDREN MEDICAL GROUP

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	2080P0203X	Pediatric Critical Care Medicine Physician

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	:	1902891492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWIFT'S CRITICAL CARE NETWORK FOR CHILDREN MEDICAL GROUP

Provider Business Mailing Address
First Line	:	3006 S MARYLAND PKWY
Second Line	:	#505
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2218
Country	:	US
Telephone Number	:	888-350-2911
Fax Number	:	702-369-5827

Provider Business Practice Location Address
First Line	:	320 W PUEBLO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4311
Country	:	US
Telephone Number	:	888-350-2911
Fax Number	:	702-369-5827

Authorized Official
Title or Position	:	OWNER / DIRECTOR
Name	:	JAMES D SWIFT
Credential	:
Telephone Number	:	888-350-2911

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	08/22/2020

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