Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
KAISER FDN HSP OUT HSP PHY 111
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
280 W MACARTHUR BLVD, OAKLAND, CA 94611-5642
(510) 752-6471
(510) 752-5637
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY PROFESSIONAL AFFAIRS, DOWNEY, CA 90242-2804
(562) 658-3671
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
HSP21955
CA
3336I0012X
Institutional Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0529149
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA219550
—
CA
Enumeration date
01/08/2007
Last updated
05/05/2021
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