Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #384
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
601 E IMPERIAL HWY, 1ST FL, LA HABRA, CA 90631-7463
(714) 213-7201
Mailing address
12254 BELLFLOWER BLVD FL2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY55659
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760902837
—
CA
01
—
2170008
PK
—
01
—
5663516
NCPDP
CA
Enumeration date
06/21/2017
Last updated
07/14/2023
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