Provider Demographics
NPI:1356448229
Name:SWIDA-SKILLEN, ELIZABETH A (DC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:SWIDA-SKILLEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 COFFEE RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-5023
Mailing Address - Country:US
Mailing Address - Phone:661-587-0700
Mailing Address - Fax:661-587-9131
Practice Address - Street 1:4550 COFFEE RD
Practice Address - Street 2:SUITE H
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5023
Practice Address - Country:US
Practice Address - Phone:661-587-0700
Practice Address - Fax:661-587-9131
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0138860OtherBLUE SHIELD NUMBER
CADC13886Medicare ID - Type UnspecifiedMEDICARE NUMBER