Provider Demographics
NPI:1265890263
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSF
Entity type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MEDICAL STAFF OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:KOSAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-353-7235
Mailing Address - Street 1:3333 CALIFORNIA ST
Mailing Address - Street 2:SUITE S1-10
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1981
Mailing Address - Country:US
Mailing Address - Phone:415-885-7268
Mailing Address - Fax:
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:415-476-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000091261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty