Provider Demographics
NPI:1912964834
Name:SWEARINGEN, DAVID ASHLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ASHLEY
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W BONITA AVE
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-2541
Mailing Address - Country:US
Mailing Address - Phone:909-394-0462
Mailing Address - Fax:
Practice Address - Street 1:425 W BONITA AVE
Practice Address - Street 2:SUITE 110B
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2541
Practice Address - Country:US
Practice Address - Phone:909-394-0462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT11528T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA410044203OtherRR WITH PHYSICIANS NET.
CASD0115280Medicaid
COOPT-2138OtherCOLORADO OPT LICENSE
CAP00115241OtherPALMETTO GBA
CAOPT11528TOtherCA OPTOMETRY LICENSE
CAOPT11528TOtherCA OPTOMETRY LICENSE
CAOPT11528TOtherCA OPTOMETRY LICENSE
CASD0115280Medicaid
CAMS0983660OtherDEA
CAU81770Medicare UPIN