Provider Demographics
NPI:1093071185
Name:CITY AND COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY AND COUNTY OF SAN FRANCISCO
Other - Org Name:ADULT IMMUNIZATION AND TRAVEL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-554-2765
Mailing Address - Street 1:101 GROVE ST
Mailing Address - Street 2:ROOM 102
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4505
Mailing Address - Country:US
Mailing Address - Phone:415-554-2625
Mailing Address - Fax:
Practice Address - Street 1:101 GROVE ST
Practice Address - Street 2:ROOM 102
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4505
Practice Address - Country:US
Practice Address - Phone:415-554-2625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local