Healthcare Provider Details

I. General information

NPI: 1730115247
Provider Name (Legal Business Name): TK SVENSSON MD & S MORROW MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 EDWARDS CT STE 105
BURLINGAME CA
94010-2421
US

IV. Provider business mailing address

25 EDWARDS CT STE 105
BURLINGAME CA
94010-2421
US

V. Phone/Fax

Practice location:
  • Phone: 650-504-3801
  • Fax:
Mailing address:
  • Phone: 650-342-1966
  • Fax: 650-685-6552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberG80502
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG80502
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG80502
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberG80502
License Number StateCA

VIII. Authorized Official

Name: DR. TRAVIS K SVENSSON
Title or Position: OWNER
Credential: MD, NP, RN
Phone: 650-342-1966