Provider Demographics
NPI:1720227515
Name:GARY M. KAWESCH M.D., INC
Entity Type:Organization
Organization Name:GARY M. KAWESCH M.D., INC
Other - Org Name:LASER EYE CENTER OF SILICON VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAWESCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-296-1010
Mailing Address - Street 1:606 SARATOGA AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2000
Mailing Address - Country:US
Mailing Address - Phone:408-296-1010
Mailing Address - Fax:408-296-1018
Practice Address - Street 1:606 SARATOGA AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-2000
Practice Address - Country:US
Practice Address - Phone:408-296-1010
Practice Address - Fax:408-296-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG066681207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty