Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
KAISER FDN HSP PHY 21A
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN RENOUARD BROWN (VP PHARMACY OPERATIONS AND SERVICES)
(510) 625-2363
Entity
Organization
Contact information
Practice address
975 SERENO DRIVE HOSP BLDG, VALLEJO, CA 94589
(707) 651-2072
(707) 651-2073
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
HSP40760
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0552643
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHB407600
—
CA
Enumeration date
01/08/2007
Last updated
05/05/2021
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