1255423968 NPI number — UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255423968 NPI number — UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UCSF MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255423968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 PARNASSUS AVE
Provider Second Line Business Mailing Address:
PO BOX 0296
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94143-0296
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-353-2742
Provider Business Mailing Address Fax Number:
415-353-2765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 PARNASSUS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94143-0296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-353-2742
Provider Business Practice Location Address Fax Number:
415-353-2765
Provider Enumeration Date:
09/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LARET
Authorized Official First Name:
MARK
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
415-353-2733

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  220000091 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: IP-30-4780417 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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