Organization
CALIFORNIA PACIFIC SPECIALTY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE GANDOLFO (DIRECTOR OFFICER)
(415) 931-3313
Entity
Organization
Contact information
Practice address
2302 FILLMORE ST, SUITE A, SAN FRANCISCO, CA 94115-1813
(415) 931-3313
(415) 931-3003
Mailing address
2302 FILLMORE ST, SUITE A, SAN FRANCISCO, CA 94115-1813
(415) 931-3313
(415) 931-3003
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ07860Z
BLUE SHIELD OF CA
CA
Enumeration date
02/14/2007
Last updated
08/22/2020
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