Healthcare Provider Details

I. General information

NPI: 1093995631
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE FL 1
SAN FRANCISCO CA
94143-0310
US

IV. Provider business mailing address

1689 19TH AVE
SAN FRANCISCO CA
94122-4517
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2138
  • Fax:
Mailing address:
  • Phone: 415-420-7572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberNP12252
License Number StateCA

VIII. Authorized Official

Name: MS. ROSANNA M SANSONE
Title or Position: PRACTICE MANAGER
Credential: NP
Phone: 415-353-2138