Organization Active NPI

Pacific Hematology Oncology Assoc

  • Specialist
  • San Francisco, CA
National Provider Identifier
1073630406
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PACIFIC HEMATOLOGY ONCOLOGY ASSOC
Practice address
2100 Webster St
225
San Francisco, CA 94115-2373
Phone
(415) 923-3876
Fax
(415) 923-3624
NPI assigned
Mar 22, 2007
Last updated
Mar 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
Ms. Liz K Kil
Title
Lead Biller
Phone
(415) 923-3876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

2100 Webster St
225
San Francisco, CA 94115-2373

Mailing address

2100 Webster St
Suite 225
San Francisco, CA 94115-2373
Phone (415) 923-3876

Other identifiers 4

IdentifierTypeStateIssuer
STATE LICENSEOtherCAC34434
STATE LICENSEOtherCAG72619
1518155357OtherCANPI
STATE LICENSEOtherCAG78339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613001023 CA Part B Supplier - Clinic/Group Practice 0648214429 Receives reassigned benefits from 5 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Locations

2100 Webster St
Ste 225
San Francisco, CA 94115
Phone (415) 923-3012

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1073630406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST",
            "address_2": "SUITE 225",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152373",
            "telephone_number": "415-923-3876",
            "fax_number": "415-923-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST",
            "address_2": "225",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152373",
            "telephone_number": "415-923-3876",
            "fax_number": "415-923-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEMATOLOGY ONCOLOGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "KIL",
        "authorized_official_first_name": "LIZ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LEAD BILLER",
        "authorized_official_telephone_number": "415-923-3876",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C34434",
            "identifier": "STATE LICENSE",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "G72619",
            "identifier": "STATE LICENSE",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518155357",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "G78339",
            "identifier": "STATE LICENSE",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.