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General NPI Number Information
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NPI Number | 1710427539
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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 | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 10601 VISCAINO PL
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City | BAKERSFIELD
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State | CA
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Zip | 93311-3153
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Country | US
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Telephone | 661-852-3697
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Fax | 661-852-3540
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Provider Business Mailing Address
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Address Line | 10601 VISCAINO PLACE
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City | BAKERSFIELD
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State | CA
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Zip | 93311
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Country | US
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Telephone | 661-852-3697
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Fax | 661-852-3540
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Authorized Official
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Title or Position | OUTPATIENT PHARMACY DIRECTOR
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Name | MRS. NOCOLE E SPRAGUE
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Credential | PHARM D
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Telephone | 661-864-3312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH49896
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License Number State | CA
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