Provider Demographics
NPI:1306406251
Name:PATRICK SWEET MD PC
Entity Type:Organization
Organization Name:PATRICK SWEET MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:619-204-6927
Mailing Address - Street 1:24270 HIGHWAY 78
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-6119
Mailing Address - Country:US
Mailing Address - Phone:619-204-6927
Mailing Address - Fax:909-248-7790
Practice Address - Street 1:131 S 6TH ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2429
Practice Address - Country:US
Practice Address - Phone:619-204-6927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRICK SWEET MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-13
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1063876688Medicaid