Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER HEALTH PLAN CYPRESS MOB PHY 371
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN RENOUARD BROWN (VP REGIONAL PHARMACY OPS & SERVICES)
(510) 219-3954
Entity
Organization
Contact information
Practice address
1190 VETERANS BLVD, FL 1 RM 1132, REDWOOD CITY, CA 94063-2037
(650) 299-3015
(650) 299-2627
Mailing address
1 KAISER PLZ FL 22, OAKLAND, CA 94612-3610
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY30676
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0560563
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA306760
—
CA
Enumeration date
01/05/2007
Last updated
03/29/2024
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