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Organization

KAISER FOUNDATION HEALTH PLAN INC

Active
Other names
Kaiser Permanente Pharmacy #100
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
3801 HOWE ST, FL-3, OAKLAND, CA 94611-5312
(510) 752-6194
Mailing address
3801 HOWE ST, FL-3, OAKLAND, CA 94611-5312
(510) 752-6194

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336M0002X
Mail Order Pharmacy
Primary
PHY55268
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2165788
PK
Enumeration date
10/19/2016
Last updated
10/24/2016
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