Healthcare Provider Details

I. General information

NPI: 1265702302
Provider Name (Legal Business Name): UCSF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE, SUITE M1201 UCSF, CTSI -
SAN FRANCISCO CA
94143-0126
US

IV. Provider business mailing address

505 PARNASSUS AVE, SUITE M1201 UCSF, CTSI
SAN FRANCISCO CA
94143-0126
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-4216
  • Fax: 415-476-0986
Mailing address:
  • Phone: 415-476-4216
  • Fax: 415-476-0986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CLARENCE BILL BALKE
Title or Position: DIRECTOR CTSI
Credential: MD
Phone: 415-476-8127