Provider Demographics
NPI:1417490970
Name:UNIVERSITY HEALTHCARE ALLIANCE
Entity Type:Organization
Organization Name:UNIVERSITY HEALTHCARE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-974-8297
Mailing Address - Street 1:2940 WHIPPLE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2857
Mailing Address - Country:US
Mailing Address - Phone:650-368-0520
Mailing Address - Fax:
Practice Address - Street 1:2940 WHIPPLE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2857
Practice Address - Country:US
Practice Address - Phone:650-368-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty