Healthcare Provider Details

I. General information

NPI: 1326180902
Provider Name (Legal Business Name): UCSF VALENCIA PEDIATRIC PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1647 VALENCIA ST
SAN FRANCISCO CA
94110-5012
US

IV. Provider business mailing address

1647 VALENCIA ST
SAN FRANCISCO CA
94110-5012
US

V. Phone/Fax

Practice location:
  • Phone: 415-647-3666
  • Fax: 415-282-3756
Mailing address:
  • Phone: 415-647-3666
  • Fax: 415-282-3756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SALLY RANKIN
Title or Position: CHAIR, DEPT FAMILY HEALTH NSG UCSF
Credential: RN,PHD
Phone: 415-502-7662