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General NPI Number Information
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NPI Number | 1407273279
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF THE PACIFIC
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 155 5TH ST POPL SUITE 407E
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-2919
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Country | US
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Telephone | 415-929-6560
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Fax | 415-929-6654
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Provider Business Mailing Address
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Address Line | 155 5TH ST POPL SUITE 407E
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-2919
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Country | US
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Telephone | 415-929-6560
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Fax | 415-929-6654
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Authorized Official
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Title or Position | ASST DEAN, BUDGET & FIN ADMIN
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Name | MR. ED PEGUEROS
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Credential |
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Telephone | 415-351-7192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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