Provider Demographics
NPI:1518083245
Name:WESTON, JANE S (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:S
Last Name:WESTON
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-3802
Mailing Address - Country:US
Mailing Address - Phone:650-363-0300
Mailing Address - Fax:650-363-0302
Practice Address - Street 1:3351 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-3802
Practice Address - Country:US
Practice Address - Phone:650-363-0300
Practice Address - Fax:650-363-0302
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG436052086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE56194Medicare UPIN
CAZZZ23243ZMedicare ID - Type Unspecified