Healthcare Provider Details

I. General information

NPI: 1508061631
Provider Name (Legal Business Name): TEDMOND CW SZETO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TED SZETO M.D.

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 GRANT ST STE 310
CONCORD CA
94520-2279
US

IV. Provider business mailing address

1450 TREAT BLVD # 300
WALNUT CREEK CA
94597-2168
US

V. Phone/Fax

Practice location:
  • Phone: 925-987-9650
  • Fax:
Mailing address:
  • Phone: 925-952-2855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA138523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: