# KAISER PERMANENTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629272026
- **Authorized official:** MR. WALTER JOSEPH DELORRELL JR. MFT (LICENSED PSYCHOTHERAPIST)
- **Authorized official phone:** (323) 298-3100

## Contact information

- **Practice address:** 5105 W GOLDLEAF CIR, LOS ANGELES, CA 90056-1269
- **Practice address phone:** (323) 298-3100
- **Practice address fax:** (323) 298-3119
- **Mailing address:** 10876 MARIETTA AVE, CULVER CITY, CA 90232-3714
- **Mailing address phone:** (310) 836-7195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | MFC 29835 | CA | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 08/22/2020