Healthcare Provider Details

I. General information

NPI: 1588024426
Provider Name (Legal Business Name): UC BERKELEY UNIVERSITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 BANCROFT WAY MC4300
BERKELEY CA
94720-4301
US

IV. Provider business mailing address

2222 BANCROFT WAY MC4300
BERKELEY CA
94720-4301
US

V. Phone/Fax

Practice location:
  • Phone: 510-643-5808
  • Fax:
Mailing address:
  • Phone: 510-643-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number642866
License Number StateCA

VIII. Authorized Official

Name: BRAD BUCHMAN
Title or Position: MD
Credential: MD
Phone: 510-642-6621