Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | G41972 | CA |
NPI | 1316023823 |
---|---|
Provider Name | Dr. Steven L. Swengel |
First Address | Saratoga, CA 95070-1444 |
Second Address | Los Gatos, CA 95032-1415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 01/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G419720 | (05) | CA |
F07960 | (02) |