Healthcare Provider Details

I. General information

NPI: 1831630920
Provider Name (Legal Business Name): KAISER FOUNDATION HEALTH PLAN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 WAINEE ST
LAHAINA HI
96761-1622
US

IV. Provider business mailing address

711 KAPIOLANI BLVD
HONOLULU HI
96813-5237
US

V. Phone/Fax

Practice location:
  • Phone: 808-243-6000
  • Fax:
Mailing address:
  • Phone: 808-432-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES G. ADAMS JR.
Title or Position: EXECUTIVE DIRECTOR, FINANCE LEADER
Credential:
Phone: 808-286-6758