Provider Demographics
NPI:1174032353
Name:GOLDEN GATE UROLOGY, INC.
Entity Type:Organization
Organization Name:GOLDEN GATE UROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE AND ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-543-2812
Mailing Address - Street 1:139 TOWNSEND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1946
Mailing Address - Country:US
Mailing Address - Phone:415-541-0800
Mailing Address - Fax:415-543-2811
Practice Address - Street 1:139 TOWNSEND ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1946
Practice Address - Country:US
Practice Address - Phone:415-541-0800
Practice Address - Fax:415-543-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site