Regents of the University of California

Key facts

NPI

1508080748

Entity type

Organization (NPI type 2)

Primary specialty

Ophthalmology Physician 207W00000X

License

220000091 (CA)

Legal business name

REGENTS OF THE UNIVERSITY OF CALIFORNIA

Practice address

95 Kirkham St
San Francisco, CA 94122

Phone

(415) 476-1442

NPI assigned

Apr 12, 2007

Organization subpart

Yes

Parent organization (as reported)

UCSF MEDICAL CENTER

Authorized official

Name

Mr. David Rein

Title

Coo

Phone

(415) 476-4003

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

• Regents of the University of California Rehabilitation Clinic/Center · San Rafael, CA · NPI 1013560960
  NPD tax ID
• Regents of the University of California Family Nurse Practitioner · San Francisco, CA · NPI 1588975759
  NPD tax ID
• Regents of the University of California Physician Assistant · San Francisco, CA · NPI 1992098115
  NPD tax ID
• UCSF Women's Hospital · San Francisco, CA · NPI 1366567349
  NPD tax ID

National Provider Directory

Tax ID family

UCSF Endocrine Associat (5 organizations share this tax ID)

Part of

UCSF Department of Pedi

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• UCSF Proctor Medical Group Doing business as

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 16, 2025.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1508080748",
    "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": "94143",
            "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": "95 KIRKHAM ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94122",
            "telephone_number": "415-476-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UCSF MEDICAL CENTER",
        "enumeration_date": "2007-04-12",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "REIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "415-476-4003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "220000091",
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "220000091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084294",
            "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 Proctor Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in San Francisco, CA · Ophthalmology Physician in California