Provider Demographics
NPI:1073652590
Name:CITY AND COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY AND COUNTY OF SAN FRANCISCO
Other - Org Name:SAN FRANCISCO GENERAL HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE DIRECTER DEPT OF PSYCHIAT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-206-5216
Mailing Address - Street 1:1426 67TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-2705
Mailing Address - Country:US
Mailing Address - Phone:415-290-4020
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-290-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16359283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital