Individual
JERRY R DWEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
725 WELCH RD, PALO ALTO, CA 94304-1601
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
G86073
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G86073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0083812
—
CA
05
—
GR0083813
—
CA
05
—
GR0083814
—
CA
05
—
GR0083815
—
CA
05
—
GR0083817
—
CA
05
—
ZZZ75341Z
—
CA
Enumeration date
02/15/2006
Last updated
10/08/2024
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