1356479984 NPI number — UNIVERSITY OF CALIFORNIA SAN FRANCISCO

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 1356479984 NPI number — UNIVERSITY OF CALIFORNIA SAN FRANCISCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF CALIFORNIA 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:
Provider Other Organization Name Type Code:
6
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:
1356479984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 CASTRO ST
Provider Second Line Business Mailing Address:
MAIN HOSPITAL, LEVEL B
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94114-1010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-476-3883
Provider Business Mailing Address Fax Number:
415-476-0379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 CASTRO ST
Provider Second Line Business Practice Location Address:
MAIN HOSPITAL, LEVEL B
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94114-1010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-476-3883
Provider Business Practice Location Address Fax Number:
415-476-0379
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CORPUZ
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS AND ADMINIST
Authorized Official Telephone Number:
415-476-3883

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  CLF 3207 , 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)





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