Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #979
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN BROWN (VP PHARMACY OPERATIONS & SVCS, NCAL)
(510) 625-2363
Entity
Organization
Contact information
Practice address
501 J ST FL 6, SACRAMENTO, CA 95814-2325
(916) 497-2240
(916) 497-2235
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(916) 497-2240
(916) 497-2235
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHY56099
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177223
PK
—
01
—
5666358
NCPDP
CA
Enumeration date
04/19/2018
Last updated
10/23/2020
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