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NPI Code Detail

MEDICARE: KAISER FOUNDATION HEALTH PLAN INC

MEDICARE: KAISER FOUNDATION HEALTH PLAN INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPHY37221CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10502547OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629125943
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAISER FOUNDATION HEALTH PLAN INC
Provider Business Mailing Address
First Line : 12254 BELLFLOWER BLVD FL 2
Second Line : PHARMACY OPERATIONS
City : DOWNEY
State : CA
Zip : 90242-2804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5 CENTERPOINTE DR
Second Line :
City : LA PALMA
State : CA
Zip : 90623-1050
Country : US
Telephone Number : 800-963-2068
Fax Number :
Authorized Official
Title or Position : VP PHARMACY OPERATIONS & SVCS, SCAL
Name : RHONDA LEE POLCHAK
Credential :
Telephone Number : 562-658-3510
Provider Enumeration Date : 01/05/2007
Last Update Date : 06/23/2023

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Directions to “KAISER FOUNDATION HEALTH PLAN INC ” Practice Location

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