Provider Demographics
NPI:1326180902
Name:UCSF VALENCIA PEDIATRIC PRACTICE
Entity Type:Organization
Organization Name:UCSF VALENCIA PEDIATRIC PRACTICE
Other - Org Name:UCSF VALENCIA HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CHAIR, DEPT FAMILY HEALTH NSG UCSF
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,PHD
Authorized Official - Phone:415-502-7662
Mailing Address - Street 1:1647 VALENCIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5012
Mailing Address - Country:US
Mailing Address - Phone:415-647-3666
Mailing Address - Fax:415-282-3756
Practice Address - Street 1:1647 VALENCIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5012
Practice Address - Country:US
Practice Address - Phone:415-647-3666
Practice Address - Fax:415-282-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care