Healthcare Provider Details

I. General information

NPI: 1356880769
Provider Name (Legal Business Name): UCSF MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 DIVISADERO ST
SAN FRANCISCO CA
94143-3400
US

IV. Provider business mailing address

1545 DIVISADERO ST
SAN FRANCISCO CA
94143-3400
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7900
  • Fax: 415-353-2583
Mailing address:
  • Phone: 415-353-7900
  • Fax: 415-353-2583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number95005271
License Number StateCA

VIII. Authorized Official

Name: MS. ERIN ANDERSEN
Title or Position: NURSE MANAGER
Credential: NP
Phone: 415-353-7900