Provider Demographics
NPI:1831352012
Name:CALIFORNIA PACIFIC MEDICAL CENTER
Entity type:Organization
Organization Name:CALIFORNIA PACIFIC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENETIC COUNSELOR SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-600-6371
Mailing Address - Street 1:3700 CALIFORNIA ST RM 4360
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1618
Mailing Address - Country:US
Mailing Address - Phone:415-600-6400
Mailing Address - Fax:
Practice Address - Street 1:3700 CALIFORNIA ST RM 4360
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1618
Practice Address - Country:US
Practice Address - Phone:415-600-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUTTER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics