Healthcare Provider Details

I. General information

NPI: 1851417547
Provider Name (Legal Business Name): KAISER FOUNDATION HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 SAND CREEK ROAD
ANTIOCH CA
94531
US

IV. Provider business mailing address

4501 SAND CREEK ROAD
ANTIOCH CA
94531
US

V. Phone/Fax

Practice location:
  • Phone: 925-813-6500
  • Fax:
Mailing address:
  • Phone: 925-813-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number550000614
License Number StateCA

VIII. Authorized Official

Name: MS. COLLEEN M MCKEOWN
Title or Position: SENIOR VICE PRESIDENT, AREA MANAGER
Credential:
Phone: 925-295-5888