Provider Demographics
NPI:1457402380
Name:SF GENERAL HOSPITAL
Entity Type:Organization
Organization Name:SF GENERAL HOSPITAL
Other - Org Name:DEPT OF PYSCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:CHARMAINE
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:ADDICTION SPECIALIST
Authorized Official - Phone:415-355-7501
Mailing Address - Street 1:50 LECH WALESA
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4506
Mailing Address - Country:US
Mailing Address - Phone:510-372-4382
Mailing Address - Fax:415-355-7408
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:SUITE 7M
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-6022
Practice Address - Fax:415-206-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL0201120808283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31945OtherBIS NUMBER