Provider Demographics
NPI:1831470947
Name:SWEIDAN, SOHL & EMAMIAN MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:SWEIDAN, SOHL & EMAMIAN MEDICAL GROUP, INC.
Other - Org Name:KIDS 1ST CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-513-3135
Mailing Address - Street 1:PO BOX 8500
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-8500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1022 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3221
Practice Address - Country:US
Practice Address - Phone:562-513-3135
Practice Address - Fax:562-513-3189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty