Provider Demographics
NPI:1790891695
Name:UCSF MEDICAL CENTER AT MOUNT ZION
Entity Type:Organization
Organization Name:UCSF MEDICAL CENTER AT MOUNT ZION
Other - Org Name:UCSF MEDICAL CENTER AT MOUNT ZION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:RYBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-353-2735
Mailing Address - Street 1:1600 DIVISADERO ST. RM A002
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-1662
Mailing Address - Country:US
Mailing Address - Phone:415-885-7374
Mailing Address - Fax:
Practice Address - Street 1:1600 DIVISADERO ST. RM A002
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-1662
Practice Address - Country:US
Practice Address - Phone:415-885-7374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UCSF MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-22
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHPE447893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy