Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #568
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
12761 SCHABARUM AVE PLAZA LEVEL RM 1100, IRWINDALE, CA 91706-6807
(833) 480-4700
Mailing address
12254 BELLFLOWER BLVD FL 2, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437618105
—
CA
01
—
5668984
NCPDP
CA
Enumeration date
03/13/2019
Last updated
03/04/2024
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