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General NPI Number Information
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NPI Number | 1740332824
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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 | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7300 N FRESNO ST OAK 2
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City | FRESNO
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State | CA
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Zip | 93720-2941
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Country | US
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Telephone | 559-448-4471
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Fax | 559-448-4320
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Provider Business Mailing Address
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Address Line | 941 E BUCKHILL RD
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City | FRESNO
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State | CA
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Zip | 93720-0771
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Country | US
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Telephone | 559-434-5914
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | DR. VAROUJIAN ALTEBARMAKIAN
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Credential | MD
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Telephone | 559-448-4500
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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 | 358513
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License Number State | CA
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