Healthcare Provider Details

I. General information

NPI: 1457604498
Provider Name (Legal Business Name): UCSF PEDIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE # M647 UCSF BENIOFF CHILDRENS HOSPITAL
SAN FRANCISCO CA
94143-0106
US

IV. Provider business mailing address

500 PARNASSUS AVE,, #M647, BOX 0106 UCSF BENIOFF CHILDREN'S HOSPITAL,
SAN FRANCISCO CA
94143-0106
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9628
  • Fax:
Mailing address:
  • Phone: 415-476-9628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number730621
License Number State

VIII. Authorized Official

Name: KATTI YANG
Title or Position: COO
Credential:
Phone: 415-476-9628