NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Permanente Phrmcy #563

  • Community/Retail Pharmacy
  • City of Industry, CA
National Provider Identifier
1760628911
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY49769 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Permanente Phrmcy #563
Practice address
12801 Crossroads Pkwy S
City of Industry, CA 91746-3502
Phone
(866) 214-7514
NPI assigned
Dec 17, 2008
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Rhonda Lee Polchak
Title
VP Pharmacy Operations & SVCS, Scal
Phone
(562) 658-3510

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY49769 CA Primary

Addresses

Primary practice location

12801 Crossroads Pkwy S
City of Industry, CA 91746-3502

Mailing address

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

Other names 1

  • Kaiser Permanente Phrmcy #563 Doing business as

Electronic endpoints 1

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

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation Hosp 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

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1760628911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD FL 2",
            "address_2": "PHARMACY OPERATIONS",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 CROSSROADS PKWY S",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917463502",
            "telephone_number": "866-214-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "POLCHAK",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VP PHARMACY OPERATIONS & SVCS, SCAL",
        "authorized_official_telephone_number": "562-658-3510"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "12801 Crossroads Pkwy S",
            "city": "City Of Industry",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917463502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Phrmcy #563",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Phrmcy #563",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in City of Industry, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.