Provider Demographics
NPI:1609830975
Name:SWENSON, SARA L (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:L
Last Name:SWENSON
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:PO BOX 276950
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-6950
Mailing Address - Country:US
Mailing Address - Phone:415-600-2402
Mailing Address - Fax:415-369-1292
Practice Address - Street 1:2100 WEBSTER ST STE 516
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2381
Practice Address - Country:US
Practice Address - Phone:415-600-2402
Practice Address - Fax:415-369-1292
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84644207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0G8464400Medicaid
CA0G8464400Medicare PIN
CA0G8464400Medicaid