Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER HOME HEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GUY ITO (MANAGER)
(909) 427-4244
Entity
Organization
Contact information
Practice address
9961 SIERRA AVE, BUILDING 3B, FONTANA, CA 92335-6720
(909) 427-4244
(909) 427-4248
Mailing address
9961 SIERRA AVE, BUILDING 3B, FONTANA, CA 92335-6720
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY41200
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565892
OTHER ID NUMBER
—
05
—
PHB365250
—
CA
Enumeration date
01/08/2007
Last updated
02/25/2008
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