Provider Demographics
NPI:1316111800
Name:ST LUKE'S HEALTH CARE CENTER
Entity type:Organization
Organization Name:ST LUKE'S HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/BILLING OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-641-2177
Mailing Address - Street 1:3555 CESAR CHAVEZ
Mailing Address - Street 2:REDWOOD ESTATE BLDG BILLING DIVISION
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4403
Mailing Address - Country:US
Mailing Address - Phone:415-641-2177
Mailing Address - Fax:415-641-2190
Practice Address - Street 1:1640 VALENCIA ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5040
Practice Address - Country:US
Practice Address - Phone:415-641-2177
Practice Address - Fax:415-641-2177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALIFORNIA PACIFIC MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA983362080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty