Healthcare Provider Details

I. General information

NPI: 1962951749
Provider Name (Legal Business Name): LILLIAN SWIERSZ, MD, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 PRICE AVE STE 100
REDWOOD CITY CA
94063-1433
US

IV. Provider business mailing address

570 PRICE AVE STE 100
REDWOOD CITY CA
94063-1433
US

V. Phone/Fax

Practice location:
  • Phone: 650-701-1882
  • Fax: 650-701-1886
Mailing address:
  • Phone: 650-701-1882
  • Fax: 650-701-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberG77806
License Number StateCA

VIII. Authorized Official

Name: DR. LILLIAN SWIERSZ
Title or Position: PRESIDENT
Credential: MD
Phone: 650-701-1882