Organization
UNIVERSITY OF THE PACIFIC
Active
Parent organization
UNIVERSITY OF THE PACIFIC
Other names
Orthodontics Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF THE PACIFIC
Authorized official
MR. ED PEGUEROS (ASST DEAN, BUDGET & FIN ADMIN)
(415) 351-7192
Entity
Organization
Contact information
Practice address
155 5TH ST, SUITE 3E, SAN FRANCISCO, CA 94103-2919
(415) 929-6501
(415) 929-6654
Mailing address
155 5TH ST, SUITE 3E, SAN FRANCISCO, CA 94103-2919
(415) 929-6501
(415) 929-6654
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G01001-03
DENTI-CAL IDENTIFICATION
CA
Enumeration date
02/28/2007
Last updated
05/17/2022
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