NPIMap

Organization Active NPI

Regents of the University of California

Doing business as UCSF Proctor Medical Group

  • Ophthalmology Physician
  • San Francisco, CA
National Provider Identifier
1508080748
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
220000091 Issued in CA
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Doing business as
UCSF Proctor Medical Group
Practice address
95 Kirkham St
San Francisco, CA 94122
Phone
(415) 476-1442
NPI assigned
Apr 12, 2007
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
UCSF MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Mr. David Rein
Title
Coo
Phone
(415) 476-4003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 220000091 CA Primary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 220000091 CA

Addresses

Primary practice location

95 Kirkham St
San Francisco, CA 94122

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
GR0084294MedicaidCA

Other names 1

  • UCSF Proctor Medical Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

National Provider Directory

National Provider Directory
Tax ID family
UCSF Endocrine Associat5 organizations share this tax ID, including this one
Part of
UCSF Mt Zion HSP Eeg Op

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "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": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "220000091",
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_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"
        }
    ]
}

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 Apr 16, 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.