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General NPI Number Information
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NPI Number | 1912972027
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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 | 02/22/2006
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1001 POTRERO AVE BLDG 1 RM 117
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3518
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Country | US
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Telephone | 628-206-6182
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Fax | 415-206-4055
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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 | INTERIM DIRECTOR
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Name | TERREL ROSS
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Credential |
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Telephone | 415-476-3625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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