NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Health Plan Fabiola 4 Phy 117

  • Community/Retail Pharmacy
  • Oakland, CA
National Provider Identifier
1083762967
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY39672 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Health Plan Fabiola 4 Phy 117
Practice address
3801 Howe St FL 4
Oakland, CA 94611
Phone
(510) 752-7644
Fax
(510) 752-7639
NPI assigned
Jan 8, 2007
Last updated
Jun 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Perry Flowers
Title
VP Acute Transitional Care
Phone
(562) 658-3510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY39672 CA Primary

Addresses

Primary practice location

3801 Howe St FL 4
Oakland, CA 94611

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2028859OtherPK
PHA396720MedicaidCA

Other names 1

  • KAISER HEALTH PLAN FABIOLA 4 PHY 117 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation Hosp 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

Locations

3801 Howe St
Fl 4
Oakland, CA 94611
Phone (510) 752-1190

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527811200000",
    "number": "1083762967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD FL 2",
            "address_2": "PHARMACY OPERATIONS",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 HOWE ST FL 4",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94611",
            "telephone_number": "510-752-7644",
            "fax_number": "510-752-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-06-01",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "VP ACUTE TRANSITIONAL CARE",
        "authorized_official_telephone_number": "562-658-3510"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY39672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2028859",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA396720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER HEALTH PLAN FABIOLA 4 PHY 117",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAISER HEALTH PLAN FABIOLA 4 PHY 117",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.