Provider Demographics
NPI:1124395629
Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAREER CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-353-9221
Mailing Address - Street 1:500 PARNASSUS AVE
Mailing Address - Street 2:MUW 405 BOX 0118
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0118
Mailing Address - Country:US
Mailing Address - Phone:415-353-8195
Mailing Address - Fax:415-353-4716
Practice Address - Street 1:500 PARNASSUS AVE
Practice Address - Street 2:MUW 405 BOX 0118
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0118
Practice Address - Country:US
Practice Address - Phone:415-353-8195
Practice Address - Fax:415-353-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital