Kaiser Permanente

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

193145 Issued in CA

Legal business name

KAISER PERMANENTE

Practice address

1200 El Camino Real
South San Francisco, CA 94080-3208

Phone

(650) 742-1350

Fax

(650) 742-1311

NPI assigned

Dec 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phyllis Jane Moore, RNNPI 1528125747

Title

NP

Phone

(650) 742-1350

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phyllis Jane Moore, NP

  • Adult Health Nurse Practitioner
  • South San Francisco, CA
  • NPI 1528125747
  Authorized official Same address or phone

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982766549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 MONTEREY AVE",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944043717",
            "telephone_number": "650-349-5676",
            "fax_number": "650-349-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EL CAMINO REAL",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803208",
            "telephone_number": "650-742-1350",
            "fax_number": "650-742-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "650-742-1350",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "193145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiser Foundation Hospitals (Kaiser FDN HSP Annex Phy 354)
• Kaiser Foundation Hospitals (Kaiser Permanente Pharmacy #358)
• Kaiser Foundation Hospitals (Kaiser Foundation Hospital South San Francisco)
• Kaiser Permanente
• Kaiser Permanente
• Grace Kajiwara, MD
• Taleen Grace Kalebjian, PHARMD
• Sarah Kalliath, DO
• Evie Alyse Stern Kalmar, MD
• George Nicholas Kalonturos, DC

• Primary Care Clinic/Center in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Primary Care Clinic/Center in California

• 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.