Provider Demographics
NPI:1952447609
Name:SWERDLOFF, LAUREN (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SWERDLOFF
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 1:1821 WILSHIRE BLVD STE 220
Mailing Address - Street 2:STE 220
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5627
Mailing Address - Country:US
Mailing Address - Phone:310-829-5189
Mailing Address - Fax:310-829-5942
Practice Address - Street 1:1821 WILSHIRE BLVD
Practice Address - Street 2:STE 220
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403
Practice Address - Country:US
Practice Address - Phone:310-829-5189
Practice Address - Fax:310-829-5942
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G677520Medicaid
P00260725DD9262OtherMEDICARE RAILROAD
CAW19292OtherMEDICARE
P00260725DD9262OtherMEDICARE RAILROAD
E90395Medicare UPIN