1679882245 NPI number — UCSF PACKAGE PRICING PROGRAM

Table of content: (NPI 1679882245)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679882245 NPI number — UCSF PACKAGE PRICING PROGRAM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UCSF PACKAGE PRICING PROGRAM
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:
Provider Other Organization Name Type Code:
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:
1679882245
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2010
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:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94143-1821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-476-1000
Provider Business Mailing Address Fax Number:

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:
94143-1821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-476-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REIN
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
415-476-4003

Provider Taxonomy Codes

  • Taxonomy code: 204F00000X , with the licence number:  220000091 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208600000X , with the licence number: 220000091 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: ZZZ61016Y . This is a "BS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".