NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Health Plan Modesto Phy

  • Community/Retail Pharmacy
  • Modesto, CA
National Provider Identifier
1689721904
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 Plan Modesto Phy
Practice address
1625 I St
Modesto, CA 95354-1121
Phone
(209) 557-1115
Fax
(209) 557-1125
NPI assigned
Jan 5, 2007
Last updated
Sep 11, 2025By the provider in NPPES
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
Lynn Riley
Title
Op Pharmacy MGR
Phone
(209) 557-1146

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PHY41599 CA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1625 I St
Modesto, CA 95354-1121

Mailing address

1625 I St
Modesto, CA 95354-1121

Other identifiers 2

IdentifierTypeStateIssuer
0543682OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHA415990MedicaidCA

Other names 1

  • KAISER HEALTH PLAN MODESTO PHY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 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

1625 I St
Modesto, CA 95354
Phone (209) 557-1115

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": "1757548800000",
    "number": "1689721904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 I ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 I ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541121",
            "telephone_number": "209-557-1115",
            "fax_number": "209-557-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OP PHARMACY MGR",
        "authorized_official_telephone_number": "209-557-1146"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "PHY41599",
            "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": "0543682",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA415990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER HEALTH PLAN MODESTO PHY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, 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.