Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Parent organization
KAISER FOUNDATION HEALTH PLAN INC
Other names
KAISER PERMANENTE PHARMACY #117
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Authorized official
RHONDA LEE POLCHAK (VP PHARMACY OPERATIONS & SVCS, SCAL)
(562) 658-3510
Entity
Organization
Contact information
Practice address
20790 MADRONA AVE, TORRANCE, CA 90503-3777
(866) 352-8288
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY37220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0564876
NCPDP
CA
05
—
1477600799
—
CA
01
—
1998606
PK
—
Enumeration date
01/05/2007
Last updated
06/13/2023
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