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General NPI Number Information
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NPI Number | 1629498225
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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 | 04/22/2014
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 280 EXEMPLA CIR
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City | LAFAYETTE
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State | CO
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Zip | 80026-3370
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Country | US
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Telephone | 720-536-7874
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Fax |
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Provider Business Mailing Address
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Address Line | 280 EXEMPLA CIRCLE
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City | LAFAYETTE
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State | CO
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Zip | 80026
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Country | US
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Telephone | 720-536-7874
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Fax |
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Authorized Official
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Title or Position | CLINICAL PHARMACIST
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Name | DR. TU T NGO
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Credential | PHARMD
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Telephone | 720-536-7874
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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 | 15256
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License Number State | CO
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