Provider Demographics
NPI:1972686939
Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER
Other - Org Name:UCSF MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LARET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-353-2733
Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:PO BOX 0296
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2204
Mailing Address - Country:US
Mailing Address - Phone:415-353-2742
Mailing Address - Fax:415-353-2765
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-353-2742
Practice Address - Fax:415-353-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000091261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
1992818256OtherMEDICARE NPI#
CAHSP40033HMedicaid