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General NPI Number Information
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NPI Number | 1740373844
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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 | 10/02/2006
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 3360 GEARY BLVD SUITE 201
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3398
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Country | US
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Telephone | 415-353-3100
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Fax | 415-353-3131
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Provider Business Mailing Address
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Address Line | 3360 GEARY BLVD SUITE 201
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3398
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Country | US
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Telephone | 415-353-3100
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Fax | 415-353-3131
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. MARK ROBERT LARET
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Credential |
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Telephone | 415-353-2733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 220000208
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License Number State | CA
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