Basic Information
| Provider Information | |||||||||
| NPI: | 1962951749 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LILLIAN SWIERSZ, MD, CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 570 PRICE AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507011882 | ||||||||
| FaxNumber: | 6507011886 | ||||||||
| Practice Location | |||||||||
| Address1: | 570 PRICE AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507011882 | ||||||||
| FaxNumber: | 6507011886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2016 | ||||||||
| LastUpdateDate: | 09/22/2016 | ||||||||
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| AuthorizedOfficialLastName: | SWIERSZ | ||||||||
| AuthorizedOfficialFirstName: | LILLIAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6507011882 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VE0102X | G77806 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Reproductive Endocrinology |
ID Information
| ID | Type | State | Issuer | Description | 1528134566 | 01 | CA | INDIVIDUAL NPI | OTHER |