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General NPI Number Information
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NPI Number | 1104136464
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Entity Type | Organization
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Legal Business Name | UCSF MEDICAL CENTER
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 513 PARNASSUS AVE SUITE S672 D
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2205
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Country | US
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Telephone | 415-502-8482
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Fax |
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Provider Business Mailing Address
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Address Line | 513 PARNASSUS AVE SUITE S672 D
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2205
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Country | US
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Telephone | 415-502-8482
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Fax |
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Authorized Official
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Title or Position | CLINICAL FELLOW
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Name | DR. ANDREA GERARD GONZALEZ
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Credential | M.D
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Telephone | 415-242-1180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281PC2000X
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Taxonomy Name | Children's Chronic Disease Hospital
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License Number | A112369
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License Number State | CA
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