NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Health Plan Cypress Mob Phy 371

  • Community/Retail Pharmacy
  • Redwood City, CA
National Provider Identifier
1750438073
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY30676 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Health Plan Cypress Mob Phy 371
Practice address
1190 Veterans Blvd
FL 1 RM 1132
Redwood City, CA 94063-2037
Phone
(650) 299-3015
Fax
(650) 299-2627
NPI assigned
Jan 5, 2007
Last updated
Mar 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Kathryn Renouard Brown
Title
VP Regional Pharmacy Ops & Services
Phone
(510) 219-3954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY30676 CA Primary

Addresses

Primary practice location

1190 Veterans Blvd
FL 1 RM 1132
Redwood City, CA 94063-2037

Mailing address

1 Kaiser PLZ FL 22
Oakland, CA 94612-3610

Other identifiers 2

IdentifierTypeStateIssuer
PHA306760MedicaidCA
0560563OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • KAISER HEALTH PLAN CYPRESS MOB PHY 371 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

1 Kaiser Plz
Fl 22
Oakland, CA 94612

1190 Veterans Blvd
Fl 1
Redwood City, CA 94063
Phone (650) 299-3004

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": "1711670400000",
    "number": "1750438073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KAISER PLZ FL 22",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 VETERANS BLVD",
            "address_2": "FL 1 RM 1132",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632037",
            "telephone_number": "650-299-3015",
            "fax_number": "650-299-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "RENOUARD",
        "authorized_official_title_or_position": "VP REGIONAL PHARMACY OPS & SERVICES",
        "authorized_official_telephone_number": "510-219-3954"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY30676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA306760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0560563",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER HEALTH PLAN CYPRESS MOB PHY 371",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAISER HEALTH PLAN CYPRESS MOB PHY 371",
            "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 Mar 29, 2024; 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.