Healthcare Provider Details

I. General information

NPI: 1417002312
Provider Name (Legal Business Name): KAISER FOUNDATION HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

IV. Provider business mailing address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

V. Phone/Fax

Practice location:
  • Phone: 562-657-4000
  • Fax: 562-657-4007
Mailing address:
  • Phone: 562-657-4000
  • Fax: 562-657-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number930000078
License Number StateCA

VIII. Authorized Official

Name: JIM A BRANCHICK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 562-657-4019