Southwestern Anesthesia Group (Swag)

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

SOUTHWESTERN ANESTHESIA GROUP (SWAG)

Practice address

5725 Soto St
Huntington Park, CA 90255-2630

Phone

(323) 587-9566

NPI assigned

May 16, 2008

Last updated

May 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Otto Evan Stallworth, M.D.

Title

President

Phone

(310) 792-3914

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1629235841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 TORRANCE BLVD STE S",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035804",
            "telephone_number": "310-792-3914",
            "fax_number": "310-792-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 SOTO ST",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552630",
            "telephone_number": "323-587-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN ANESTHESIA GROUP (SWAG)",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "STALLWORTH",
        "authorized_official_first_name": "OTTO",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-792-3914",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Central Family Health Center (SCFHC Florence Health Center)
• South Central Family Health Center (Huntington Park Family Health Center)
• South Coast Surgery Center Inc (South Coast Surgery Center)
• Southern California Podiatry Group, Inc. (DSP)
• Southern California Surgery Center, Inc
• Damani Spearman
• Roxanne Spencer
• Lodie Nanette Spurlock, PA-C
• St Lucia Eye Center Medical Corp
• Ava Nicole Stanko

• Anesthesiology Physician in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.