Provider Demographics
NPI:1922291160
Name:JANE S. WESTON, M.D. , MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JANE S. WESTON, M.D. , MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WESTPM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-363-0300
Mailing Address - Street 1:3351 EL CAMINO REAL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-3811
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:SUITE 201
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-3811
Practice Address - Country:US
Practice Address - Phone:650-363-0300
Practice Address - Fax:650-363-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43605208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty