Provider Demographics
NPI:1750043261
Name:SWAIN, JUDITH LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:LEA
Last Name:SWAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 SIERRA MAR DR
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-3857
Mailing Address - Country:US
Mailing Address - Phone:858-344-9691
Mailing Address - Fax:
Practice Address - Street 1:7730 SIERRA MAR DR
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-3857
Practice Address - Country:US
Practice Address - Phone:858-344-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33241207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease