Healthcare Provider Details

I. General information

NPI: 1689774093
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST
SAN FRANCISCO CA
94143-2350
US

IV. Provider business mailing address

505 PARNASSUS AVE PO BOX 0296
SAN FRANCISCO CA
94143-0296
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-3000
  • Fax: 415-353-2765
Mailing address:
  • Phone: 415-353-2742
  • Fax: 415-353-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number220000091
License Number StateCA

VIII. Authorized Official

Name: MR. MARK ROBERT LARET
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 415-353-2733