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General NPI Number Information
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NPI Number | 1184920076
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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 | 02/10/2011
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Last Update Date | 02/10/2011
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Provider Practice Location Address
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Address Line | 580 NORTH TREELINE DRIVE APT 107
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 818-523-2248
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Fax |
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Provider Business Mailing Address
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Address Line | 580 TREELINE DR UNIT 107
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City | CORONA
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State | CA
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Zip | 92879-1197
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Country | US
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Telephone | 818-523-2248
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Fax |
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Authorized Official
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Title or Position | RESIDENT PHYSICIAN
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Name | JULINA HARMANDJIAN
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Credential | MD
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Telephone | 818-523-2248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | A114490
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License Number State | CA
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