Provider Demographics
NPI:1376813295
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:CHIEF OF PEDIATRIC UROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-476-1611
Mailing Address - Street 1:2355 SCOTT ST
Mailing Address - Street 2:APT 301
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1768
Mailing Address - Country:US
Mailing Address - Phone:415-624-6918
Mailing Address - Fax:
Practice Address - Street 1:2355 SCOTT ST
Practice Address - Street 2:APT 301
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1768
Practice Address - Country:US
Practice Address - Phone:415-624-6918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652635261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center