Healthcare Provider Details

I. General information

NPI: 1861957326
Provider Name (Legal Business Name): KAISER FOUNDATION HEALTH PLAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9521 DALEN ST RM R
DOWNEY CA
90242-4847
US

IV. Provider business mailing address

12254 BELLFLOWER BLVD FL 2
DOWNEY CA
90242-2804
US

V. Phone/Fax

Practice location:
  • Phone: 866-523-6059
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM PERRY FLOWERS
Title or Position: VP ACUTE TRANSITIONAL CARE
Credential:
Phone: 562-658-3082