Healthcare Provider Details

I. General information

NPI: 1336294040
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: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25825 SOUTH VERMONT AVE
HARBOR CITY CA
90710-3518
US

IV. Provider business mailing address

25825 SOUTH VERMONT AVE
HARBOR CITY CA
90710-3518
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-5111
  • Fax:
Mailing address:
  • Phone: 310-325-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number930000079
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number930000079
License Number StateCA

VIII. Authorized Official

Name: LESLEY A WILLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 310-517-2745