=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124176003
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KAISER FOUNDATION HEALTH PLAN INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2238 GEARY BLVD FL 5
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94115-3416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-833-8552
-----------------------------------------------------
Fax | 415-833-8560
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2238 GEARY BLVD FL 5
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94115-3416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | LILY LEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 415-833-8652
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number | PHY44496
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------