Provider Demographics
NPI:1407632565
Name:ELIZABETH SWENSON, M.D., P.C.
Entity Type:Organization
Organization Name:ELIZABETH SWENSON, M.D., P.C.
Other - Org Name:TEAL MEDICAL GROUP OF CALIFORNIA, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEAD OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-294-0775
Mailing Address - Street 1:1012 TORNEY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-1704
Mailing Address - Country:US
Mailing Address - Phone:415-294-0775
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty