Provider Demographics
NPI:1114094331
Name:SWENSON, ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:650-321-4121
Mailing Address - Fax:
Practice Address - Street 1:1012 TORNEY AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94129-1704
Practice Address - Country:US
Practice Address - Phone:415-294-0775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT74905207V00000X
FLME156610207V00000X
IL036161084207V00000X
MDD97025207V00000X
MI4301509682207V00000X
NC2025-00892207V00000X
NJ25MA11781000207V00000X
NMMD2023-1159207V00000X
NY316916207V00000X
ORMD224629207V00000X
PAMD481082207V00000X
AK236545207V00000X
ARE-19556207V00000X
CODR.0071018207V00000X
CAA82186207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI41632Medicare UPIN