Healthcare Provider Details

I. General information

NPI: 1598996225
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE M691
SAN FRANCISCO CA
94131-0110
US

IV. Provider business mailing address

505 PARNASSUS AVE M691
SAN FRNACISCO CA
94131-0110
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberA108840
License Number StateCA

VIII. Authorized Official

Name: CATHERINE RATTI
Title or Position: PEDIATRIC RESIDENCY PROGRAM MANAGER
Credential:
Phone: 415-476-5001