Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #221
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
4405 VANDEVER AVE FL 2, SAN DIEGO, CA 92120-3315
(619) 516-7311
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHY 51240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5646217
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/02/2013
Last updated
06/14/2023
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