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Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Oncology Pharmacy #868
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEE POLCHAK (VP PHARMACY OPERATIONS & SVCS, SCAL)
(562) 658-3510
Entity
Organization
Contact information
Practice address
75036 GERALD FORD DR FL 1 RM 152F, PALM DESERT, CA 92211-2080
(760) 834-2508
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHY49950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5635000
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/16/2009
Last updated
03/04/2024
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