Provider Demographics
NPI:1881050821
Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OF MEDICAL GENETICS
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSSBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-476-3200
Mailing Address - Street 1:1600 DIVISADERO ST
Mailing Address - Street 2:CANCER GENETICS AND PREVENTION PROGRAM, BOX 1714
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-3010
Mailing Address - Country:US
Mailing Address - Phone:415-885-7779
Mailing Address - Fax:415-885-3787
Practice Address - Street 1:1600 DIVISADERO ST
Practice Address - Street 2:CANCER GENETICS AND PREVENTION PROGRAM, BOX 1714
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-3010
Practice Address - Country:US
Practice Address - Phone:415-885-7779
Practice Address - Fax:415-885-3787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000689170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty