Provider Demographics
NPI:1497307128
Name:CPMC FOUNDATION
Entity Type:Organization
Organization Name:CPMC FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN CONRAD
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:UY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:650-392-5756
Mailing Address - Street 1:1 ESTATE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1454
Mailing Address - Country:US
Mailing Address - Phone:650-392-5756
Mailing Address - Fax:
Practice Address - Street 1:1101 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6919
Practice Address - Country:US
Practice Address - Phone:415-600-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital