Healthcare Provider Details

I. General information

NPI: 1386686087
Provider Name (Legal Business Name): CITY & COUNTY OF SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 WISCONSIN STREET
SAN FRANCISCO CA
94107
US

IV. Provider business mailing address

1001 POTRERO AVENUE BUILDING 10 WARD 14 ROOM 1405
SAN FRANCISCO CA
94110
US

V. Phone/Fax

Practice location:
  • Phone: 415-920-1250
  • Fax: 415-550-1639
Mailing address:
  • Phone: 415-206-8338
  • Fax: 206-206-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY ARNOLD
Title or Position: DEPUTY DIRECTOR, PFS
Credential:
Phone: 415-759-3351