1760788038 NPI number — UHS AT CALIFORNIA BERKELY TANG CENTER

Table of content: (NPI 1760788038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760788038 NPI number — UHS AT CALIFORNIA BERKELY TANG CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UHS AT CALIFORNIA BERKELY TANG 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:
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:
1760788038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2222 BANCROFT WAY SPC 4300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERKELEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94720-4300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-643-7177
Provider Business Mailing Address Fax Number:
510-643-9790

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2222 BANCROFT AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94720-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-643-7177
Provider Business Practice Location Address Fax Number:
510-643-9790
Provider Enumeration Date:
02/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SORGI
Authorized Official First Name:
VIRGINIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CAREER RN ALLERGY/TRAVEL
Authorized Official Telephone Number:
510-643-7177

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X , with the licence number:  267742 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X , with the licence number: 267742 , 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: 267742 . This is a "26LEVEL ONE HEALTH CARE PROVIDER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 163W00000X . This is a "LEVEL 1 PROVIDER RN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com