Healthcare Provider Details
I. General information
NPI: 1952834400
Provider Name (Legal Business Name): UCSF
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2017
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
513 PARNASSUS AVE S-321
SAN FRANCISCO CA
94143-2205
US
IV. Provider business mailing address
513 PARNASSUS AVE S-321
SAN FRANCISCO CA
94143-2205
US
V. Phone/Fax
- Phone: 415-476-1239
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1000X |
| Taxonomy | Student Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANTHONY
TURK
Title or Position: RESIDENT
Credential:
Phone: 949-922-2804