Healthcare Provider Details

I. General information

NPI: 1548031289
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ILLINOIS STREET STE D1201
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

520 ILLINOIS STREET STE D1201, BOX 0108
SAN FRANCISCO CA
94158
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-3717
  • Fax:
Mailing address:
  • Phone: 415-514-3717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE CANARI
Title or Position: EXEC DIRECTOR, GOVERNMENT REIMB
Credential:
Phone: 415-353-4739