Healthcare Provider Details

I. General information

NPI: 1164765509
Provider Name (Legal Business Name): UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCSF ANESTHESIA RESIDENCY 513 PARNASSUS AVE., S436
SAN FRANCISCO CA
94143-0001
US

IV. Provider business mailing address

UCSF ANESTHESIA RESIDENCY 513 PARNASSUS AVE., S436
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-3781
  • Fax:
Mailing address:
  • Phone: 415-514-3781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: DENISE PAMELA CHANG
Title or Position: ANESTHESIOLOGY RESIDENT
Credential: M.D.
Phone: 919-491-5878