Basic Information
| Provider Information | |||||||||
| NPI: | 1558595470 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY OF CALIFORNIA, SAN FRANCISCO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 PARNASSUS AVENUE | ||||||||
| Address2: | ROOM M-987 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154761528 | ||||||||
| FaxNumber: | 4155021976 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 PARNASSUS AVE | ||||||||
| Address2: | ROOM M-987 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154761528 | ||||||||
| FaxNumber: | 4155021976 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2009 | ||||||||
| LastUpdateDate: | 05/06/2009 | ||||||||
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| AuthorizedOfficialLastName: | HOLLANDER | ||||||||
| AuthorizedOfficialFirstName: | HARRY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | RESIDENCY PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4154761528 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | A107434 | CA | Y | Hospitals | General Acute Care Hospital |
No ID Information.