Healthcare Provider Details
I. General information
NPI: 1730643933
Provider Name (Legal Business Name): KAISER FOUNDATION HEALTH PLAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2019
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1292 WAIANUENUE AVE
HILO HI
96720-1228
US
IV. Provider business mailing address
711 KAPIOLANI BLVD
HONOLULU HI
96813-5237
US
V. Phone/Fax
- Phone: 808-934-4000
- Fax:
- Phone: 808-432-5340
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
G.
ADAMS
JR.
Title or Position: EXECUTIVE DIRECTOR, FINANCE LEADER
Credential:
Phone: 808-286-6758