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General NPI Number Information
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NPI Number | 1710231998
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 505 PARNASSUS AVE SUITE M1291 MAILBOX 0126
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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 | 415-476-4336
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Fax |
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Provider Business Mailing Address
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Address Line | 505 PARNASSUS AVE SUITE M1291 MAILBOX 0126
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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 | 415-476-4336
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Fax |
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Authorized Official
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Title or Position | DIVISION ADMINISTRATOR
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Name | MS. JENNIFER N LEE
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Credential |
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Telephone | 415-502-4831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | C23520
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License Number State | CA
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