Provider Demographics
NPI:1689094708
Name:SWIMMER, RACHEL TANSIONGCO (DMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:TANSIONGCO
Last Name:SWIMMER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 ILLION ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2362
Mailing Address - Country:US
Mailing Address - Phone:619-208-1085
Mailing Address - Fax:
Practice Address - Street 1:875 ORANGE AVE STE 210
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-2662
Practice Address - Country:US
Practice Address - Phone:619-435-6655
Practice Address - Fax:619-435-6644
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1005931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry