Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER HEALTH PLAN MAIN PHY 381
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN RENOUARD BROWN (VP PHARMACY OPERATIONS AND SERVICES)
(510) 625-2363
Entity
Organization
Contact information
Practice address
770 E CALAVERAS BLVD, MILPITAS, CA 95035-5491
(408) 945-2645
(408) 945-2730
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY30252
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0528628
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA302520
—
CA
Enumeration date
01/05/2007
Last updated
11/27/2020
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