NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

  • Community/Retail Pharmacy
  • San Francisco, CA
National Provider Identifier
1255488573
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY35832 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Practice address
1635 Divisadero St FL 3
San Francisco, CA 94115-3036
Phone
(415) 833-4507
Fax
(415) 833-3719
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X PHY35832 CA Primary

Addresses

Primary practice location

1635 Divisadero St FL 3
San Francisco, CA 94115-3036

Mailing address

12254 Bellflower Blvd FL 2
Pharmacy Professional Affairs
Downey, CA 90242-2804
Phone (562) 658-3671

Other identifiers 2

IdentifierTypeStateIssuer
PHA358320MedicaidCA
0508993OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • KAISER HEALTH PLAN DIVISADERO PHY 314 Doing business as

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

Locations

1635 Divisadero St
Fl 3
San Francisco, CA 94115
Phone (415) 833-2020

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1255488573",
    "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",
            "telephone_number": "562-658-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153036",
            "telephone_number": "415-833-4507",
            "fax_number": "415-833-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2011-12-21",
        "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": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY35832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA358320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0508993",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER HEALTH PLAN DIVISADERO PHY 314",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.