Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #658
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEE POCHAK (VP PHARMACY OPERATIONS & SVCS, SCAL)
(562) 658-3510
Entity
Organization
Contact information
Practice address
3750 GRAND AVE, 1ST FL, CHINO, CA 91710-5478
(909) 902-5024
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
PHY55574
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740721372
—
CA
01
—
2168611
PK
—
01
—
5662766
NCPDP
CA
Enumeration date
03/15/2017
Last updated
03/04/2024
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