Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #005C
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
4900 W SUNSET BLVD STE 164, LOS ANGELES, CA 90027-5814
(323) 783-8719
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHY51418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139490
PK
—
01
—
5646902
NCPDP
CA
Enumeration date
03/19/2013
Last updated
06/23/2023
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