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General NPI Number Information
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NPI Number | 1528401080
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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 | 04/15/2013
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Last Update Date | 04/15/2013
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Provider Practice Location Address
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Address Line | 3495 PIEDMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-1717
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Country | US
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Telephone | 404-949-5375
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 PIEDMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-1717
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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 | PGY-1 MANAGED CARE PHARMACY RESIDEN
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Name | NEELAM PATEL
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Credential |
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Telephone | 404-949-5375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | RPH026665
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License Number State | GA
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