Healthcare Provider Details

I. General information

NPI: 1629657689
Provider Name (Legal Business Name): URSULA GRIFFITHS-RANDOLPH MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST FL 4
SAN FRANCISCO CA
94143-2549
US

IV. Provider business mailing address

550 16TH ST FL 4
SAN FRANCISCO CA
94143-2549
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1664
  • Fax:
Mailing address:
  • Phone: 415-502-2362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPTL6491
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA183640
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberPTL6491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: