Provider Demographics
NPI: | 1477624104 |
---|---|
Name: | UCSF MEDICAL GROUP BUSINESS SERVICES |
Entity Type: | Organization |
Organization Name: | UCSF MEDICAL GROUP BUSINESS SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DAVE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | REIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 415-476-4003 |
Mailing Address - Street 1: | 3333 CALIFORNIA ST STE S1-10 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN FRANCISCO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94118-1981 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 415-885-7268 |
Mailing Address - Fax: | 415-885-7445 |
Practice Address - Street 1: | 400 PARNASSUS AVE |
Practice Address - Street 2: | |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94122-2721 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-353-2808 |
Practice Address - Fax: | 415-353-2956 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | UCSF MEDICAL CENTER |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-11-13 |
Last Update Date: | 2019-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 220000091 | 207N00000X, 207R00000X, 207RN0300X, 207RX0202X, 207T00000X, 207V00000X, 207W00000X, 207X00000X, 207Y00000X, 2084N0400X, 208600000X, 208800000X |
207RH0003X, 363L00000X, 363LA2100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | GR0084297 | Medicaid | |
CA | GR0084297 | Medicaid |