NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Health Walnut Pediatric Phy

  • Community/Retail Pharmacy
  • Redwood City, CA
National Provider Identifier
1407904238
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Health Walnut Pediatric Phy
Practice address
610 Walnut St
Redwood City, CA 94063-2049
Phone
(650) 299-2565
Fax
(650) 299-2618
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Simon Chow
Title
Op Pharmacy MGR
Phone
(650) 299-4176

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PHY20825 CA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

610 Walnut St
Redwood City, CA 94063-2049

Mailing address

610 Walnut St
Redwood City, CA 94063-2049

Other identifiers 2

IdentifierTypeStateIssuer
0569395OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHA208250MedicaidCA

Other names 1

  • KAISER HEALTH WALNUT PEDIATRIC PHY 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

610 Walnut St
Redwood City, CA 94063
Phone (650) 299-2015

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": "1757548800000",
    "number": "1407904238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 WALNUT ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WALNUT ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632049",
            "telephone_number": "650-299-2565",
            "fax_number": "650-299-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CHOW",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "OP PHARMACY MGR",
        "authorized_official_telephone_number": "650-299-4176"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "PHY20825",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0569395",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA208250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER HEALTH WALNUT PEDIATRIC PHY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.