Healthcare Provider Details

I. General information

NPI: 1295088177
Provider Name (Legal Business Name): UCSF MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE A 68
SAN FRANCISCO CA
94143-0228
US

IV. Provider business mailing address

612 MARIPOSA AVE APT 316
OAKLAND CA
94610-1363
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number11902
License Number StateCA

VIII. Authorized Official

Name: JESSICA W MOK
Title or Position: OCCUPATIONAL THERAPIST II
Credential: OTR/L
Phone: 510-965-7236