{
"Npi": {
"NPI": "1093987950",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SWETMAN",
"FirstName": "GLENDA",
"MiddleName": "LOUISE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "QUICK",
"OtherFirstName": "GLENDA",
"OtherMiddleName": "SWETMAN",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "450 BROADWAY ST",
"SecondLineMailingAddress": "PAVILION C, 2ND FLOOR, MC 5334",
"MailingAddressCityName": "REDWOOD CITY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94063-3132",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "650-721-7194",
"MailingAddressFaxNumber": "650-721-7194",
"FirstLinePracticeLocationAddress": "450 BROADWAY ST",
"SecondLinePracticeLocationAddress": "PAVILION C, 2ND FLOOR, MC 5334",
"PracticeLocationAddressCityName": "REDWOOD CITY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94063-3132",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-721-7194",
"PracticeLocationAddressFaxNumber": "650-721-7194",
"EnumerationDate": "03/31/2008",
"LastUpdateDate": "01/14/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207N00000X",
"TaxonomyName": "Dermatology Physician",
"LicenseNumber": "MD.200362",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207N00000X",
"TaxonomyName": "Dermatology Physician",
"LicenseNumber": "A108202",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}