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Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #162
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
9961 SIERRA AVE, MOB 3 BASEMENT RM#1-B800, FONTANA, CA 92335-6720
(909) 427-4941
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
PHY47314
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111836
PK
—
01
—
5624754
NCPDP
CA
Enumeration date
12/29/2006
Last updated
06/13/2023
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