Michael Shwayder MD a Professional Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

W14324 Issued in CA

Legal business name

MICHAEL SHWAYDER MD A PROFESSIONAL CORPORATION

Practice address

6801 Park Terrace Dr
Suite 530B
Los Angeles, CA 90045-1543

Phone

(310) 301-0015

Fax

(310) 301-4882

NPI assigned

Oct 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael W T Shwayder, M.D.

Title

President

Phone

(310) 301-0015

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1437338100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 PARK TERRACE DR",
            "address_2": "SUITE 530B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "310-301-0015",
            "fax_number": "310-301-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TERRACE DR",
            "address_2": "SUITE 530B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "310-301-0015",
            "fax_number": "310-301-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL SHWAYDER MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "SHWAYDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-301-0015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "W14324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "W14324",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.