Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #206R
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
6911 CONVOY CT FL 1 RM 1501, SAN DIEGO, CA 92111-1014
(866) 385-2632
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720607112
—
CA
01
—
5672349
NCPDP
CA
Enumeration date
04/15/2020
Last updated
06/14/2023
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