Provider Demographics
NPI:1629598552
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSF
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSF
Other - Org Name:UCSF CLINICAL INTEGRATED PARTNERS, DIGNITY HEALTH MEDICAL FOUNDATION
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, MEDICAL STAFF
Authorized Official - Prefix:
Authorized Official - First Name:KOSAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-885-7268
Mailing Address - Street 1:3333 CALIFORNIA ST # 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:
Mailing Address - Fax:
Practice Address - Street 1:2250 HAYES ST STE 302
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1078
Practice Address - Country:US
Practice Address - Phone:415-379-2912
Practice Address - Fax:415-666-3144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSF
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty