Healthcare Provider Details

I. General information

NPI: 1003062159
Provider Name (Legal Business Name): UNIVERSITY CALIFORNIA SAN FRANCISCO DEPARTMENT OF PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 PARNASSUS AVE U 585 BOX 0748
SAN FRANCISCO CA
94143-0001
US

IV. Provider business mailing address

533 PARNASSUS AVE U 585 BOX 0748
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2423
  • Fax:
Mailing address:
  • Phone: 415-476-2423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberA99645
License Number StateCA

VIII. Authorized Official

Name: DR. DANIEL RANCH
Title or Position: CLINICAL FELLOW
Credential: M.D.
Phone: 415-476-2423