Basic Information
| Provider Information | |||||||||
| NPI: | 1093801524 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA PACIFIC ORTHOPAEDICS AND SPORTS MEDICINE A MEDICAL CORPORAT | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CALIFORNIA PACIFIC ORTHOPAEDICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3838 CALIFORNIA ST. | ||||||||
| Address2: | SUITE 715 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155922017 | ||||||||
| FaxNumber: | 4155920001 | ||||||||
| Practice Location | |||||||||
| Address1: | 3838 CALIFORNIA ST. | ||||||||
| Address2: | SUITE 715 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155922017 | ||||||||
| FaxNumber: | 4155920001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 03/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | URBANSKI | ||||||||
| AuthorizedOfficialFirstName: | KATHERINE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4155922017 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.