Healthcare Provider Details

I. General information

NPI: 1437218567
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 MISSION STREET
SAN FRANCISCO CA
94103
US

IV. Provider business mailing address

P.O. BOX 7464
SAN FRANCISCO CA
94120-7464
US

V. Phone/Fax

Practice location:
  • Phone: 415-597-8000
  • Fax: 415-597-8004
Mailing address:
  • Phone: 415-502-7648
  • Fax: 415-476-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1041C0700X
License Number StateCA

VIII. Authorized Official

Name: GRACE FERNANDEZ
Title or Position: DIRECTOR
Credential:
Phone: 415-206-8969