Provider Demographics
NPI:1104964717
Name:T. WARREN SCHWEITZER MD INC
Entity type:Organization
Organization Name:T. WARREN SCHWEITZER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:T.
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-851-8577
Mailing Address - Street 1:2995 WOODSIDE RD # 211
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2446
Mailing Address - Country:US
Mailing Address - Phone:650-851-8577
Mailing Address - Fax:650-851-8054
Practice Address - Street 1:80 WHY WORRY LN
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:CA
Practice Address - Zip Code:94062-3654
Practice Address - Country:US
Practice Address - Phone:650-851-8577
Practice Address - Fax:650-851-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-03
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41885207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3650518Medicaid
CA3650518Medicaid
CA00G418850Medicare PIN