Healthcare Provider Details

I. General information

NPI: 1720264039
Provider Name (Legal Business Name): HEALTH NET OF CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21281 BURBANK BLVD
WOODLAND HILLS CA
91367-6607
US

IV. Provider business mailing address

7700 FORSYTH BLVD
SAINT LOUIS MO
63105-1813
US

V. Phone/Fax

Practice location:
  • Phone: 800-431-9007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: KENNETH KOSHOREK
Title or Position: VP, ASSOCIATE GENERAL COUNSEL
Credential:
Phone: 313-720-5567