Healthcare Provider Details

I. General information

NPI: 1477627537
Provider Name (Legal Business Name): UCSF DEPT OF SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-6505
US

IV. Provider business mailing address

2001 THE EMBARCADERO STE 1500
SAN FRANCISCO CA
94143-5200
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2161
  • Fax: 415-353-2505
Mailing address:
  • Phone: 415-885-7268
  • Fax: 415-885-7445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number220000091
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number220000091
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number220000091
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number220000091
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number220000091
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number220000091
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number220000091
License Number StateCA

VIII. Authorized Official

Name: MR. KOSAL BO
Title or Position: VICE PRESIDENT, MEDICAL STAFF GOV
Credential:
Phone: 415-353-7235