1386686087 NPI number — CITY & COUNTY OF SAN FRANCISCO

Table of content: (NPI 1386686087)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386686087 NPI number — CITY & COUNTY OF SAN FRANCISCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY & COUNTY OF SAN FRANCISCO
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:
POTRERO HILL HEALTH CENTER
Provider Other Organization Name Type Code:
5
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:
1386686087
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 POTRERO AVENUE
Provider Second Line Business Mailing Address:
BUILDING 10 WARD 14 ROOM 1405
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-206-8338
Provider Business Mailing Address Fax Number:
206-206-3837

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 WISCONSIN STREET
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:
94107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-920-1250
Provider Business Practice Location Address Fax Number:
415-550-1639
Provider Enumeration Date:
06/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ISTVAN
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
DIRECTOR OF PFS
Authorized Official Telephone Number:
415-759-4064

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: FHC11691G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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