# KAISER PERMANENTE

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

## Provider details

- **NPI number:** 1780847053
- **Authorized official:** MRS. MARY-JEANNE H DER AVEDISSIAN MS RD CNSD (ASSISTANT DIRECTOR)
- **Authorized official phone:** (323) 783-1552

## Contact information

- **Practice address:** 4867 W SUNSET BLVD, LOS ANGELES, CA 90027-5969
- **Practice address phone:** (323) 783-1552
- **Practice address fax:** (323) 783-0026
- **Mailing address:** 4867 W SUNSET BLVD, LOS ANGELES, CA 90027-5969
- **Mailing address fax:** (323) 783-0026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 590756 | CA | Yes |

## Other

- **Enumeration date:** 07/08/2008
- **Last updated:** 07/08/2008