Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
KAISER PERMANENTE PHARMACY 985
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KVANCZ (VP NAT'L PHRMCY PROG & SVCS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
9521 D DALEN STREET ROOM R, DOWNEY, CA 90242
(562) 401-4209
(562) 401-2378
Mailing address
9521 D DALEN STREET ROOM R, DOWNEY, CA 90242
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY41612
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563951
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA416120
—
CA
Enumeration date
01/08/2007
Last updated
05/05/2021
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