Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Parent organization
KAISER FOUNDATION HEALTH PLAN INC
Other names
Kaiser Permanente Pharmacy #374C
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Authorized official
DAVID KVANCZ (VP NAT'L PHRMCY PROG & SVCS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
6650 ALTON PKWY, BLDG 2 FL 4 RM 4262, IRVINE, CA 92618-3734
(949) 932-2530
Mailing address
6650 ALTON PKWY, BLDG 2 FL 4 RM 4262, IRVINE, CA 92618-3734
(949) 932-2530
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY53420
CA
3336C0004X
Compounding Pharmacy
Primary
PHY53420
CA
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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