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General NPI Number Information
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NPI Number | 1033430319
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 204 S ARNAZ DR APT 3
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2818
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Country | US
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Telephone | 213-215-5142
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Fax |
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Provider Business Mailing Address
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Address Line | 6041 CADILLAC AVE ENDOCRINOLOGY DEPT #220
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City | LOS ANGELES
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State | CA
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Zip | 90034-1702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DEPARTMENT ADMINISTRATOR
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Name | MARICA SUE LEE
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Credential |
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Telephone | 323-857-4142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 17657
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License Number State | CA
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