Provider Demographics
NPI:1205656527
Name:UCSF DENTAL ONCOLOGY -UNIVERSITY PROJECT
Entity type:Organization
Organization Name:UCSF DENTAL ONCOLOGY -UNIVERSITY PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RIJUTA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DHERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-895-6533
Mailing Address - Street 1:PO BOX 741649
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-1649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:513 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2205
Practice Address - Country:US
Practice Address - Phone:415-476-1731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UCSF DENTAL ONCOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental