Provider Demographics
NPI:1366467482
Name:SWEARINGEN, STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 N HARBOR BLVD
Mailing Address - Street 2:STE. 111
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1355
Mailing Address - Country:US
Mailing Address - Phone:714-871-9080
Mailing Address - Fax:714-871-4459
Practice Address - Street 1:1235 N HARBOR BLVD
Practice Address - Street 2:STE. 111
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1355
Practice Address - Country:US
Practice Address - Phone:714-871-9080
Practice Address - Fax:714-871-4459
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC12073Medicare ID - Type Unspecified