Organization Active NPI

University of California San Francisco Medical Center

Doing business as UCSF Lakeside Senior Medical Center

  • Geriatric Medicine (Internal Medicine) Physician
  • San Francisco, CA
National Provider Identifier
1306982533
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER
Doing business as
UCSF Lakeside Senior Medical Center
Practice address
2501 Ocean Ave
San Francisco, CA 94143-0001
Phone
(415) 353-4900
NPI assigned
Jan 29, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Jed Shivers
Title
Coo
Phone
(415) 476-4003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CA
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X CA Primary

Addresses

Primary practice location

2501 Ocean Ave
San Francisco, CA 94143-0001

Mailing address

1635 Divisadero St
Suite 625, Box 1821
San Francisco, CA 94143-0001
Phone (415) 476-4029

Other names 1

  • UCSF Lakeside Senior Medical Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1306982533",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 OCEAN AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-353-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2025-09-11",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSF Lakeside Senior Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 11, 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.