MEDICARE: UCSF MEDICAL GROUP BUSINESS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RH0003X	Hematology & Oncology Physician
2	207RX0202X	Medical Oncology Physician
3	2085R0001X	Radiation Oncology Physician
4	2086X0206X	Surgical Oncology Physician
5	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1811705031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UCSF MEDICAL GROUP BUSINESS SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 880003
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90088-0003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 CALIFORNIA DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4145
Country	:	US
Telephone Number	:	650-341-9131
Fax Number	:	650-341-9135

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NICHOLAS WONG
Credential	:
Telephone Number	:	415-353-7249

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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