Provider Demographics
NPI:1851435341
Name:CALIFORNIA PACIFIC MEDICAL CENTER
Entity Type:Organization
Organization Name:CALIFORNIA PACIFIC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-600-4256
Mailing Address - Street 1:2300 CALIFORNIA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2754
Mailing Address - Country:US
Mailing Address - Phone:415-600-3503
Mailing Address - Fax:415-600-1327
Practice Address - Street 1:2300 CALIFORNIA ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2754
Practice Address - Country:US
Practice Address - Phone:415-600-3503
Practice Address - Fax:415-600-1327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54733261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE80898Medicare UPIN