Kaiser Foundation Health Plan Inc

Organization Active NPI Compounding Pharmacy · San Rafael, CA

NPI 1093192577 · NPPES record last updated Jun 1, 2018

Key facts

NPI
1093192577
Entity type
Organization (NPI type 2)
Primary specialty
Compounding Pharmacy 3336C0004X
License
PHY52494 (CA)
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Practice address
99 Montecillo Rd
BLDG 2 FL-5 RM 5254
San Rafael, CA 94903
Phone
(415) 444-2319
NPI assigned
May 4, 2015
Organization subpart
Yes
Parent organization (as reported)
KAISER FOUNDATION HEALTH PLAN INC

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Kaiser FDN HLTH Plan Phcy (379 organizations share this tax ID)
Part of
Kaiser FDN HLTH Plan Phcy

Locations

99 Montecillo Rd
Bldg 2
San Rafael, CA 94903
Phone (415) 444-2319

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY52494 CA
Compounding Pharmacy 3336C0004X PHY52494 CA Yes

Addresses

Primary practice location

99 Montecillo Rd
BLDG 2 FL-5 RM 5254
San Rafael, CA 94903

Mailing address

99 Montecillo Rd
BLDG 2 FL-5 RM 5254
San Rafael, CA 94903-3308

Other names

  • Kaiser Permanente Pharmacy #397 Other name

Other providers in San Rafael, CA

All providers in San Rafael, CA · Compounding Pharmacy in California

Sources for this page

Verify at the official NPI Registry.