MEDICARE: SAWONA BISWAS MS, CGC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	GC001104	CA

General Provider Information

NPI Number	:	1871056390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAWONA BISWAS MS, CGC

Provider Business Mailing Address
First Line	:	651 N EL CAMINO REAL APT 305
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94401-3725
Country	:	US
Telephone Number	:	617-633-7618
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Second Line	:	1600 DIVISADERO ST
City	:	SAN FRANSISCO
State	:	CA
Zip	:	94115
Country	:	US
Telephone Number	:	415-567-6600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	04/11/2019

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