Provider Demographics
NPI:1497073688
Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Other - Org Name:DEPARTMENT OF LABORATORY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPARTMENT CHAIR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:415-476-5510
Mailing Address - Street 1:FILE 31298
Mailing Address - Street 2:P.O. BOX 60000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94160-0001
Mailing Address - Country:US
Mailing Address - Phone:415-353-4807
Mailing Address - Fax:415-353-4828
Practice Address - Street 1:185 BERRY ST
Practice Address - Street 2:SUITE 290
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-5705
Practice Address - Country:US
Practice Address - Phone:415-353-4807
Practice Address - Fax:415-353-4828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory