Provider Demographics
NPI:1093987950
Name:SWETMAN, GLENDA LOUISE (MD)
Entity Type:Individual
Prefix:MRS
First Name:GLENDA
Middle Name:LOUISE
Last Name:SWETMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:GLENDA
Other - Middle Name:SWETMAN
Other - Last Name:QUICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:450 BROADWAY ST
Mailing Address - Street 2:PAVILION C, 2ND FLOOR, MC 5334
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-3132
Mailing Address - Country:US
Mailing Address - Phone:650-721-7194
Mailing Address - Fax:650-721-7194
Practice Address - Street 1:450 BROADWAY ST
Practice Address - Street 2:PAVILION C, 2ND FLOOR, MC 5334
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-3132
Practice Address - Country:US
Practice Address - Phone:650-721-7194
Practice Address - Fax:650-721-7194
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200362207N00000X
CAA108202207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology