Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #338
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
3782 W MARTIN LUTHER KING JR BLVD, 1ST FL, LOS ANGELES, CA 90008-0000
(866) 536-1310
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY55766
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY55766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790201929
—
CA
01
—
5664075
NCPDP
CA
Enumeration date
08/18/2017
Last updated
06/12/2023
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