NPIMap

Organization Active NPI

Kaiser Permanente

  • Managed Care Organization Pharmacy
  • Daly City, CA
National Provider Identifier
1730380452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
PHA46565 Issued in CA
Legal business name
KAISER PERMANENTE
Practice address
395 Hickey Blvd
1St Floor Pharmacy
Daly City, CA 94015-2770
Phone
(650) 301-5700
Fax
(650) 301-5780
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Irene Phan, PHARM.D.
Title
Pharmacy Manager
Phone
(650) 301-5781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Managed Care Organization Pharmacy 3336M0003X PHA46565 CA Primary

Addresses

Primary practice location

395 Hickey Blvd
1St Floor Pharmacy
Daly City, CA 94015-2770

Mailing address

395 Hickey Blvd
1St Floor Pharmacy
Daly City, CA 94015-2770
Phone (650) 301-5700

Other identifiers 1

IdentifierTypeStateIssuer
PHA465650OtherCAMEDI-CAL PROVIDER NUMBER

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730380452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 HICKEY BLVD",
            "address_2": "1ST FLOOR PHARMACY",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152770",
            "telephone_number": "650-301-5700",
            "fax_number": "650-301-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 HICKEY BLVD",
            "address_2": "1ST FLOOR PHARMACY",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152770",
            "telephone_number": "650-301-5700",
            "fax_number": "650-301-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "650-301-5781",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "CA",
            "license": "PHA46565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NUMBER",
            "identifier": "PHA465650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.