Healthcare Provider Details

I. General information

NPI: 1366513509
Provider Name (Legal Business Name): KAISER FOUNDATION HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SERENO DR
VALLEJO CA
94589-2441
US

IV. Provider business mailing address

975 SERENO DR
VALLEJO CA
94589-2441
US

V. Phone/Fax

Practice location:
  • Phone: 707-651-1000
  • Fax:
Mailing address:
  • Phone: 707-651-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number110000026
License Number StateCA

VIII. Authorized Official

Name: NORAIR JEMJEMIAN
Title or Position: SENIOR VICE PRESIDENT/AREA MANAGER
Credential:
Phone: 707-651-5414