Provider Demographics
NPI:1881123065
Name:SWIGER, CALLIE (LAC)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:SWIGER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 RODNEY DR APT 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2092
Mailing Address - Country:US
Mailing Address - Phone:339-221-1309
Mailing Address - Fax:
Practice Address - Street 1:2123 RODNEY DR APT 207
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2092
Practice Address - Country:US
Practice Address - Phone:339-221-1309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16190171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist