Healthcare Provider Details

I. General information

NPI: 1982468567
Provider Name (Legal Business Name): GOLDEN GATE UROLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 MISSION ST
SAN FRANCISCO CA
94103-2413
US

IV. Provider business mailing address

1661 MISSION ST
SAN FRANCISCO CA
94103-2413
US

V. Phone/Fax

Practice location:
  • Phone: 415-541-0800
  • Fax: 415-543-2811
Mailing address:
  • Phone: 415-463-1615
  • Fax: 415-463-1615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: NICOLE GAFFNEY
Title or Position: REVENUE CYCLE MANAGEMENT, LEAD
Credential:
Phone: 415-463-1615