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Kaiser Foundation Health Plan Inc

Organization Active NPI Community/Retail Pharmacy · Walnut Creek, CA

NPI 1194873984 · NPPES record last updated Oct 7, 2020

Key facts

NPI
1194873984
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHY40642 (CA)
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Practice address
1425 S Main St FL 1
Walnut Creek, CA 94596-5318
Phone
(925) 295-4464
Fax
(925) 295-4462
NPI assigned
Jan 8, 2007
Organization subpart
No

Authorized official

Name
Kathryn Renouard Brown
Title
VP Pharmacy Operations and Services
Phone
(510) 625-2363

Corporate family (same tax ID) 24

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

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

Locations

1425 S Main St
Fl 1
Walnut Creek, CA 94596
Phone (925) 295-4461

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY40642 CA Yes
Institutional Pharmacy 3336I0012X

Addresses

Primary practice location

1425 S Main St FL 1
Walnut Creek, CA 94596-5318

Mailing address

1800 Harrison St FL 13
Oakland, CA 94612-3466

Other identifiers

IdentifierTypeStateIssuer
0549747OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHB406420MedicaidCA

Other names

  • KAISER HEALTH PLAN MOB 1 PHY 511 Doing business as

Other providers in Walnut Creek, CA

All providers in Walnut Creek, CA · Community/Retail Pharmacy in California

Sources for this page

Verify at the official NPI Registry.