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Organization
THOMAS R. SWANSON OD, INC
Active
Organization
THOMAS R. SWANSON OD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R SWANSON OD (PRESIDENT OWNER)
(916) 786-6633
Entity
Organization
Contact information
Practice address
1821 DOUGLAS BLVD STE C4, ROSEVILLE, CA 95661-2910
(916) 786-6633
(916) 786-6617
Mailing address
1821 DOUGLAS BLVD, SUITE C4, ROSEVILLE, CA 95661-2910
(916) 786-6633
(916) 786-6617
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
65701T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE3871
RAILROAD MEDICARE
CA
05
—
SD0065700
—
CA
01
—
ZZZ66845Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/20/2006
Last updated
01/04/2013
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