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General NPI Number Information
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NPI Number | 1700057908
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 2540 23RD STREET, BUILDING 7, 3RD FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 415-476-2124
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Fax | 415-514-7748
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Provider Business Mailing Address
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Address Line | PO BOX 743749
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City | LOS ANGELES
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State | CA
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Zip | 90074-3749
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Country | US
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Telephone | 415-514-3000
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Fax | 415-502-8175
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Authorized Official
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Title or Position | DIRECTOR
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Name | JUANITA VILLANUEVA
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Credential |
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Telephone | 415-514-2574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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