Provider Demographics
NPI:1992827992
Name:ATHERTON PLASTIC SURGERY CENTER
Entity Type:Organization
Organization Name:ATHERTON PLASTIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:WESTON
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 200
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 200
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:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2200269261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical