Healthcare Provider Details

I. General information

NPI: 1396094272
Provider Name (Legal Business Name): UCSF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 DIVISADERO ST STE 480
SAN FRANCISCO CA
94115-3011
US

IV. Provider business mailing address

1701 DIVISADERO ST STE 480
SAN FRANCISCO CA
94115-3011
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-8393
  • Fax: 415-353-9539
Mailing address:
  • Phone: 415-353-8393
  • Fax: 415-353-9539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberF5742
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberF5742
License Number StateCA

VIII. Authorized Official

Name: MELISSENT ZUMWALT
Title or Position: MANAGER NEUROLOGY
Credential:
Phone: 415-502-7777