Basic Information
| Provider Information | |||||||||
| NPI: | 1992898837 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHINESE HOSPITAL ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 845 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941334851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159822400 | ||||||||
| FaxNumber: | 4159822440 | ||||||||
| Practice Location | |||||||||
| Address1: | 845 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941334851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159822400 | ||||||||
| FaxNumber: | 4156772440 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 03/14/2013 | ||||||||
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| AuthorizedOfficialLastName: | STAUFFER | ||||||||
| AuthorizedOfficialFirstName: | JUDITH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER, PATIENT FINANCIAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 4156772315 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 220000122 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207P00000X | 220000122 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | 282N00000X | 220000122 | CA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | HSC00407F | 05 | CA | MEDICAID | ZZR00407F | 05 | CA | MEDICAID | HSP40407F | 05 | CA | MEDICAID |