Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY #531
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEE POLCHAK (VP PHARMACY OPERATIONS & SVCS, SCAL)
(562) 658-3510
Entity
Organization
Contact information
Practice address
27200 IRIS AVE, MOB 2 FL 1, MORENO VALLEY, CA 92555-4802
(877) 722-0916
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
PHY 51238
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659617124
—
CA
01
—
5646281
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/02/2013
Last updated
06/22/2023
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