Kaiser Foundation Health Plan Inc
Organization Active NPI Community/Retail Pharmacy · Cudahy, CA
NPI 1013064336 · NPPES record last updated Jun 23, 2023
Key facts
- NPI
- 1013064336
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHY37385 (CA)
- Legal business name
- KAISER FOUNDATION HEALTH PLAN INC
- Practice address
- 7825 Atlantic Ave
Cudahy, CA 90201-5022 - Phone
- (866) 340-5613
- NPI assigned
- Jan 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Rhonda Lee Polchak
- Title
- VP Pharmacy Operations & SVCS, Scal
- Phone
- (562) 658-3510
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Kaiser FDN HLTH Plan Phcy
Locations
7825 Atlantic Ave
Cudahy, CA 90201
Phone (323) 562-6475
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY37385 | CA | Yes |
Addresses
Primary practice location
7825 Atlantic Ave
Cudahy, CA 90201-5022
Mailing address
12254 Bellflower Blvd FL 2
Pharmacy Operations
Downey, CA 90242-2804
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013064336 | Medicaid | CA | |
| 0563204 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- KAISER PERMANENTE PHARMACY #67
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) |
Other providers in Cudahy, CA
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- Kai-Ning Jan
- Jardosh DDS and Bhakta DMD Dental Corporation
- Kachis Pharmacy Inc
- In Kook Kim
- Cheryl Y. Kono
- Laarni Gutierrez-Darvin MD Inc
- Ladan Zinati DDS Inc
- Jeffrey Chung Lee
All providers in Cudahy, CA · Community/Retail Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.