University of California San Francisco Medical Center

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

220000091 Issued in CA

Legal business name

UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER

Doing business as

UCSF Dermatology

Practice address

400 Parnassus Ave
MCB 300
San Francisco, CA 94143-2202

Phone

(415) 353-7800

Fax

(415) 353-7870

NPI assigned

Nov 3, 2006

Last updated

Apr 15, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jed Shivers

Title

Coo

Phone

(415) 476-4003

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• UCSF Dermatology Doing business as

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1033298617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 625, BOX 1821",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-476-4029",
            "fax_number": "415-476-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE",
            "address_2": "MCB 300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432202",
            "telephone_number": "415-353-7800",
            "fax_number": "415-353-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "SHIVERS",
        "authorized_official_first_name": "JED",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "415-476-4003"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "220000091",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "220000091",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "220000091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR008429M",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UCSF Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University of California San Francisco (UCSF Pediatrics Group)
• University of California San Francisco
• University of California San Francisco
• University of California San Francisco (UCSF Medical Center Adult Chronic Dialysis)
• University of California San Francisco Medical Center (UCSF Medical Center)
• University of California San Francisco Medical Center (UCSF Internal Medicine)
• University of California San Francisco Medical Center (UCSF Pain Management Center)
• University of California San Francisco Medical Center (UCSF OB/GYN Group)
• University of California San Francisco Medical Center (UCSF Ophthalmology Group)
• University of California San Francisco Medical Center

• Dermatology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.