Provider Demographics
NPI:1023151057
Name:UCSF HEALTH COMMUNITY HOSPITALS
Entity type:Organization
Organization Name:UCSF HEALTH COMMUNITY HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-514-6118
Mailing Address - Street 1:PO BOX 885904
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-5904
Mailing Address - Country:US
Mailing Address - Phone:415-353-4739
Mailing Address - Fax:
Practice Address - Street 1:SAN FRANCISCO INTERNATIONAL AIRPORT
Practice Address - Street 2:INTERNATIONAL TERMINAL, LEVEL 3, A SIDE, HWY 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94128-3128
Practice Address - Country:US
Practice Address - Phone:415-688-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UCSF HEALTH COMMUNITY HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-15
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000071261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04911ZOtherBLUE SHIELD
912152210OtherIRS
193623600OtherDEPT. OF LABOR
CAZZZ04911ZOtherBLUE SHIELD
CAZZZ28589ZMedicare PIN