Provider Demographics
NPI:1841405230
Name:SAN FRANCSICO GENERAL HOSPITAL RENAL CENTER
Entity Type:Organization
Organization Name:SAN FRANCSICO GENERAL HOSPITAL RENAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEP
Authorized Official - Middle Name:
Authorized Official - Last Name:POON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-476-4617
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:BUILDING 100, ROOM 342
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-476-4617
Mailing Address - Fax:415-282-8182
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:BUILDING 100, ROOM 342
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-476-4617
Practice Address - Fax:415-282-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA052397281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital