Provider Demographics
NPI:1518970409
Name:GREENSWEIG, GARY A (DO)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:A
Last Name:GREENSWEIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 ALAMEDA DE LAS PULGAS
Mailing Address - Street 2:ATTN: SONDRA WEEKS; HOSPITAL ADMINISTRATION
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2751
Mailing Address - Country:US
Mailing Address - Phone:650-367-5817
Mailing Address - Fax:650-367-5288
Practice Address - Street 1:1301 SHOREWAY RD
Practice Address - Street 2:STE. 100
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-4151
Practice Address - Country:US
Practice Address - Phone:650-596-7000
Practice Address - Fax:650-596-7093
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E08759Medicare UPIN