Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER HEALTH PLAN PEDIATRIC PHY
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY BAUTISTA (OP PHARMACY MGR)
(916) 688-6474
Entity
Organization
Contact information
Practice address
6600 BRUCEVILLE RD, SACRAMENTO, CA 95823-4671
(916) 688-6474
(916) 688-2251
Mailing address
6600 BRUCEVILLE RD, SACRAMENTO, CA 95823-4671
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
PHY39586
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565462
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA395860
—
CA
Enumeration date
01/05/2007
Last updated
09/11/2025
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