Healthcare Provider Details

I. General information

NPI: 1629136817
Provider Name (Legal Business Name): CALIFORNIA PACIFIC MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO STREET
SAN FRANCISCO CA
94114
US

IV. Provider business mailing address

PO BOX 7999
SAN FRANCISCO CA
94115
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-7180
  • Fax: 415-600-7185
Mailing address:
  • Phone: 415-600-7180
  • Fax: 415-600-7185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number220000197
License Number StateCA

VIII. Authorized Official

Name: MICHAEL P HOLDSWORTH
Title or Position: VP OF ADMINISTRATIONS CFO
Credential:
Phone: 415-600-3959