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General NPI Number Information
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NPI Number | 1396909834
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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 | 07/14/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 5119 POMONA BLVD # 2416
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City | LOS ANGELES
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State | CA
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Zip | 90022-1711
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Country | US
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Telephone | 323-881-5596
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 S ELECTRIC AVE
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City | ALHAMBRA
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State | CA
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Zip | 91803-4516
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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 | AMBULATORY CARE PHARMACIST
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Name | DR. MARIE FRANCE MARTINEZ
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Credential | PHARM.D.
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Telephone | 323-881-5596
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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 | RPH58624
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License Number State | CA
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