Provider Demographics
NPI:1386627842
Name:SWENNING, TODD A (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:SWENNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1623
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1057
Mailing Address - Country:US
Mailing Address - Phone:760-416-4511
Mailing Address - Fax:909-533-2225
Practice Address - Street 1:1180 N INDIAN CANYON DR STE 201
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4857
Practice Address - Country:US
Practice Address - Phone:760-416-4511
Practice Address - Fax:909-533-2225
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2018-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK24640207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
H75201Medicare UPIN