Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #524
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
28150 KELLER RD, 1ST FL, MURRIETA, CA 92563
(855) 431-5906
Mailing address
12254 BELLFLOWER BLVD FL 2, ATTN: TERESA RIVERA, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
(951) 672-5305
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY55779
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093232282
—
CA
01
—
2171667
PK
—
01
—
5664342
NCPDP
CA
Enumeration date
08/28/2017
Last updated
03/04/2024
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