Kaiser Health Plan Modesto Phy

LBN: Kaiser Foundation Health Plan Inc
Kaiser Health Plan Modesto Phy is an health care organization with primary practice located at 1625 I St , Modesto CA 95354-1121. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Inc can be contacted via phone (209) 557-1115, or through Riley, Lynn via phone (209) 557-1146.

Contact Information

Primary practice address
1625 I St Modesto CA 95354-1121
Phone: (209) 557-1115
Fax: (209) 557-1125
Website:
Map and Directions
Authorized official contact:
Name: Riley, Lynn
Phone: (209) 557-1146

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X PHY41599 California
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1689721904
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Health Plan Modesto Phy
Authorized official Riley, Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689721904 NPPES
California MEDICAID PHA415990
California Other 0543682

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