Basic Information
| Provider Information | |||||||||
| NPI: | 1851435341 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CALIFORNIA PACIFIC MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 CALIFORNIA ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156003503 | ||||||||
| FaxNumber: | 4156001327 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 CALIFORNIA ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156003503 | ||||||||
| FaxNumber: | 4156001327 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | IMBERT | ||||||||
| AuthorizedOfficialFirstName: | ANABEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF MEDICAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4156004256 | ||||||||
| 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 | 261QM2500X | G54733 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
No ID Information.