Basic Information
| Provider Information | |||||||||
| NPI: | 1518970409 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREENSWEIG | ||||||||
| FirstName: | GARY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 ALAMEDA DE LAS PULGAS | ||||||||
| Address2: | ATTN: SONDRA WEEKS; HOSPITAL ADMINISTRATION | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940622751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503675817 | ||||||||
| FaxNumber: | 6503675288 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 SHOREWAY RD | ||||||||
| Address2: | STE. 100 | ||||||||
| City: | BELMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940024151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505967000 | ||||||||
| FaxNumber: | 6505967093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 12/11/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A4368 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.