Kaiser Foundation Health Plan Inc

Organization Active NPI Compounding Pharmacy · Baldwin Park, CA

NPI 1689059396 · NPPES record last updated Jun 21, 2023

Key facts

NPI
1689059396
Entity type
Organization (NPI type 2)
Primary specialty
Compounding Pharmacy 3336C0004X
License
PHY53441 (CA)
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Practice address
1011 Baldwin Park Blvd
FL-1, RM #1122
Baldwin Park, CA 91706-5806
Phone
(626) 851-6143
NPI assigned
Jul 23, 2015
Organization subpart
No

Authorized official

Name
Rhonda Lee Polchak
Title
VP Pharmacy Operations & SVCS, Scal
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)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY53441 CA
Compounding Pharmacy 3336C0004X PHY53441 CA Yes

Addresses

Primary practice location

1011 Baldwin Park Blvd
FL-1, RM #1122
Baldwin Park, CA 91706-5806

Mailing address

12254 Bellflower Blvd FL 2
Pharmacy Operations
Downey, CA 90242-2804

Other names

  • Kaiser Permanente Pharmacy #551C Other name

Electronic endpoints

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

Other providers in Baldwin Park, CA

All providers in Baldwin Park, CA · Compounding Pharmacy in California

Sources for this page

Verify at the official NPI Registry.