Healthcare Provider Details

I. General information

NPI: 1982955126
Provider Name (Legal Business Name): KAISER PERMANENTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 GEARY BLVD
SAN FRANCISCO CA
94115-3358
US

IV. Provider business mailing address

2425 GEARY BLVD.
SAN FRANCISCO CA
94109
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-4515
  • Fax:
Mailing address:
  • Phone: 415-833-4515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number615299
License Number StateCA

VIII. Authorized Official

Name: DANA SUE NELSON
Title or Position: MANAGER
Credential:
Phone: 415-833-4515