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General NPI Number Information
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NPI Number | 1588198402
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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 | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 9945 VALGRANDE WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-3004
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Country | US
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Telephone | 916-296-3512
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Fax |
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Provider Business Mailing Address
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Address Line | 9945 VALGRANDE WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-3004
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Country | US
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Telephone | 916-296-3512
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | ANJANA PATEL
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Credential | PHARM D
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Telephone | 916-296-3512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | RPH54607
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License Number State | CA
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