NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

  • Community/Retail Pharmacy
  • Campbell, CA
National Provider Identifier
1073661815
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY46383 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Practice address
200 E Hacienda Ave
Campbell, CA 95008-6617
Phone
(408) 871-5860
Fax
(408) 871-5865
NPI assigned
Jan 8, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
David Kvancz
Title
VP Nat'L Pharmacy Prog & SVCS
Phone
(562) 658-3510

National Provider Directory

National Provider Directory
Tax ID family
Kaiser FDN HLTH Plan Phcy379 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY46383 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

200 E Hacienda Ave
Campbell, CA 95008-6617

Mailing address

12254 Bellflower Blvd FL 2
Pharmacy Professional Affairs
Downey, CA 90242-2804

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
PHA463830MedicaidCA
5600615OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

NPPES NPI Registry
  • KAISER PERMANENTE PHARMACY #452 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 23, 2012.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1073661815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD FL 2",
            "address_2": "PHARMACY PROFESSIONAL AFFAIRS",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E HACIENDA AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086617",
            "telephone_number": "408-871-5860",
            "fax_number": "408-871-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "KVANCZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP NAT'L PHARMACY PROG & SVCS",
        "authorized_official_telephone_number": "562-658-3510"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA463830",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5600615",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER PERMANENTE PHARMACY #452",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.