Provider Demographics
NPI:1023362134
Name:CALIFORNIA PACIFIC MEDICAL CENTER
Entity Type:Organization
Organization Name:CALIFORNIA PACIFIC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR, DEPARTMENT OF OPHTHALMOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-600-3930
Mailing Address - Street 1:2340 CLAY ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1932
Mailing Address - Country:US
Mailing Address - Phone:917-553-7684
Mailing Address - Fax:
Practice Address - Street 1:2340 CLAY ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1932
Practice Address - Country:US
Practice Address - Phone:917-553-7684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115783282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA115783OtherMEDICAL BOARD OF CALIFORNIA