Organization
UCSF CENTER FOR CRANIOFACIAL ANOMALIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES N BERTOLAMI (DEAN)
(415) 476-1323
Entity
Organization
Contact information
Practice address
513 PARNASSUS AVENUE S-747, SAN FRANCISCO, CA 94143-0442
(415) 476-2271
(415) 476-9513
Mailing address
513 PARNASSUS AVENUE S-747, SAN FRANCISCO, CA 94143-0442
(415) 476-2271
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
CA
1223P0221X
Pediatric Dentistry
—
CA
1223P0700X
Prosthodontics
—
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
CA
207N00000X
Dermatology Physician
—
CA
207NP0225X
Pediatric Dermatology Physician
—
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072
DELTA DENTAL PROVIDER #
CA
01
—
G01072-01
DENTI-CAL PROVIDER #
CA
01
—
GR0040390
MEDI-CAL PROVIDER #
CA
Enumeration date
11/06/2006
Last updated
09/11/2025
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