Provider Demographics
NPI:1598705451
Name:CITY & COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO
Other - Org Name:HEALTH CENTER #5
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PFS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ISTVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-759-4064
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:BUILDING 10 WARD 14 ROOM 1405
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8338
Mailing Address - Fax:206-206-3837
Practice Address - Street 1:1351 24TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1616
Practice Address - Country:US
Practice Address - Phone:415-682-1900
Practice Address - Fax:415-753-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC11741FMedicaid
CAZZZ21662ZMedicare PIN