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General NPI Number Information
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NPI Number | 1588860951
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Entity Type | Organization
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Legal Business Name | KAISER FOUNDATION HEALTH PLAN INC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 4501 SAND CREEK RD 1ST FLR RM 1125
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City | ANTIOCH
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State | CA
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Zip | 94531-8687
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Country | US
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Telephone | 925-813-7940
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 HARRISON ST FL 13
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City | OAKLAND
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State | CA
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Zip | 94612-3466
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Country | US
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Telephone | 925-826-2542
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Fax | 510-625-3307
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Authorized Official
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Title or Position | VP PHARMACY OPERATIONS & SERVICES
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Name | KATHRYN RENOUARD BROWN
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Credential |
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Telephone | 510-625-2363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY48581
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License Number State | CA
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