Healthcare Provider Details

I. General information

NPI: 1073877064
Provider Name (Legal Business Name): UCSF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 EDDY ST APT 301
SAN FRANCISCO CA
94115-4175
US

IV. Provider business mailing address

1535 EDDY ST APT 301
SAN FRANCISCO CA
94115-4175
US

V. Phone/Fax

Practice location:
  • Phone: 415-443-4640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: DR. ADRIAN J. COON
Title or Position: RESIDENT
Credential: M.D.
Phone: 630-452-1805