Provider Demographics
NPI:1801016035
Name:PAN PACIFIC UROLOGY
Entity Type:Organization
Organization Name:PAN PACIFIC UROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARLIP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-202-0251
Mailing Address - Street 1:2100 WEBSTER ST STE 222
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2376
Mailing Address - Country:US
Mailing Address - Phone:415-202-0251
Mailing Address - Fax:
Practice Address - Street 1:2100 WEBSTER ST STE 222
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2376
Practice Address - Country:US
Practice Address - Phone:415-202-0251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ37311ZMedicare ID - Type Unspecified