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General NPI Number Information
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NPI Number | 1265890263
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSF
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 06/21/2017
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Provider Practice Location Address
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Address Line | 505 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2204
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Country | US
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Telephone | 415-476-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 CALIFORNIA ST SUITE S1-10
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1981
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Country | US
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Telephone | 415-885-7268
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, MEDICAL STAFF OFFICE
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Name | MR. KOSAL BO
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Credential |
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Telephone | 415-353-7235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 220000091
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License Number State | CA
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