Provider Demographics
NPI:1235420399
Name:PHADNIS, SWAPNA VAYUVEGULA (MD)
Entity type:Individual
Prefix:
First Name:SWAPNA
Middle Name:VAYUVEGULA
Last Name:PHADNIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SWAPNA
Other - Middle Name:
Other - Last Name:VAYUVEGULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:23141 VERDUGO DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1341
Mailing Address - Country:US
Mailing Address - Phone:949-215-5055
Mailing Address - Fax:949-326-5099
Practice Address - Street 1:23141 VERDUGO DR STE 201
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1341
Practice Address - Country:US
Practice Address - Phone:949-215-5055
Practice Address - Fax:949-326-5099
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135159207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine