Swetha Annam

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Tulare, CA

NPI 1093560427 · NPPES record last updated Apr 19, 2024

Key facts

NPI
1093560427
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
849 N. Cherry St.
Tulare, CA 93274
Phone
(559) 688-0821
NPI assigned
Apr 19, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241202001347 CA Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
4284169145

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

849 N. Cherry St.
Tulare, CA 93274

Mailing address

586 W Fargo Ave Apt C
Hanford, CA 93230-7181
Phone (469) 753-6896

Other providers in Tulare, CA

All providers in Tulare, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.