Provider Demographics
NPI:1003965328
Name:PACIFIC HEIGHTS SURGERY CENTER OF SAN FRANCISCO LP
Entity Type:Organization
Organization Name:PACIFIC HEIGHTS SURGERY CENTER OF SAN FRANCISCO LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:ODELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-282-7472
Mailing Address - Street 1:3000 CALIFORNIA ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2411
Mailing Address - Country:US
Mailing Address - Phone:415-561-1171
Mailing Address - Fax:
Practice Address - Street 1:3000 CALIFORNIA ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2411
Practice Address - Country:US
Practice Address - Phone:415-561-1171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000492261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical