Provider Demographics
NPI:1396166435
Name:SKIN CANCER CENTER OF SILICON VALLEY INC
Entity type:Organization
Organization Name:SKIN CANCER CENTER OF SILICON VALLEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MOHS SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-688-2082
Mailing Address - Street 1:800 POLLARD RD
Mailing Address - Street 2:BLDG A
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1415
Mailing Address - Country:US
Mailing Address - Phone:408-688-2082
Mailing Address - Fax:
Practice Address - Street 1:800 POLLARD RD
Practice Address - Street 2:BLDG A
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1415
Practice Address - Country:US
Practice Address - Phone:408-688-2082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty