Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER HEALTH PLAN MB PHY 113
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT CARVER (VP PHRMCY STRATEGY OPERATIONS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
255 W MACARTHUR BLVD, OAKLAND, CA 94611-5641
(510) 752-7864
(510) 752-7464
Mailing address
255 W MACARTHUR BLVD, OAKLAND, CA 94611-5641
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY33939
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0556160
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA339390
—
CA
Enumeration date
01/08/2007
Last updated
05/20/2010
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