NPIMap

Organization Active NPI

Kaiser Foundation Hospitals

Doing business as Kaiser Hospital Discharge Phy #119

  • Community/Retail Pharmacy
  • Oakland, CA
National Provider Identifier
1205984028
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY42092 Issued in CA
Legal business name
KAISER FOUNDATION HOSPITALS
Doing business as
Kaiser Hospital Discharge Phy #119
Practice address
280 W Macarthur Blvd
Oakland, CA 94611-5642
Phone
(510) 752-6957
Fax
(510) 752-7441
NPI assigned
Jan 8, 2007
Last updated
Apr 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
David Kvancz
Title
VP Nat'L Phrmcy Prog & SVCS
Phone
(562) 658-3510

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY42092 CA Primary
Institutional Pharmacy 3336I0012X NU

Addresses

Primary practice location

280 W Macarthur Blvd
Oakland, CA 94611-5642

Mailing address

12254 Bellflower Blvd
Pharmacy Operations
Downey, CA 90242-2804

Other identifiers 2

IdentifierTypeStateIssuer
PHA420920MedicaidCA
1999933OtherPK

Other names 1

  • KAISER HOSPITAL DISCHARGE PHY #119 Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation185 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

12254 Bellflower Blvd
Downey, CA 90242
Phone (562) 658-4010

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": "1619136000000",
    "number": "1205984028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD",
            "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": "280 W MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115642",
            "telephone_number": "510-752-6957",
            "fax_number": "510-752-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "KVANCZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP NAT'L PHRMCY PROG & SVCS",
        "authorized_official_telephone_number": "562-658-3510"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY42092",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA420920",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1999933",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "280 W MacArthur Blvd",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "KAISER HOSPITAL DISCHARGE PHY #119",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAISER HOSPITAL DISCHARGE PHY #119",
            "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 Apr 23, 2021; 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.