Provider Demographics
NPI:1073516498
Name:SWAIM, JOHN F (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SWAIM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 SISTER MARY COLUMBA
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4327
Mailing Address - Country:US
Mailing Address - Phone:530-527-7584
Mailing Address - Fax:530-527-1604
Practice Address - Street 1:2530 SISTER MARY COLUMBA
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4327
Practice Address - Country:US
Practice Address - Phone:530-527-7584
Practice Address - Fax:530-527-1604
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2015-04-16
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
CAE4348213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4504060001Medicare NSC
CAU85745Medicare UPIN
CABD101ZMedicare PIN