Provider Demographics
NPI:1356489025
Name:STONEWALL PROJECT, UCSF
Entity Type:Organization
Organization Name:STONEWALL PROJECT, UCSF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DISCEPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-502-5703
Mailing Address - Street 1:3180 18TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2043
Mailing Address - Country:US
Mailing Address - Phone:415-502-5775
Mailing Address - Fax:
Practice Address - Street 1:3180 18TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2043
Practice Address - Country:US
Practice Address - Phone:415-502-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare