Healthcare Provider Details

I. General information

NPI: 1922282532
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE.
SAN FRANCISCO CA
94143
US

IV. Provider business mailing address

513 PARNASSUS AVE. ROOM S-704. P.O. BOX 0422
SAN FRANCISCO CA
94143-0422
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-3276
  • Fax:
Mailing address:
  • Phone: 415-476-5063
  • Fax: 415-476-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number56084
License Number StateCA

VIII. Authorized Official

Name: DR. PAM DENBESTEN
Title or Position: PROFESSOR/PEDIATRIC DENTISTRY CHAIR
Credential: D.D.S., M.S.
Phone: 415-502-7828