Kaiser Health Plan Mob 2 Phy 686

LBN: Kaiser Foundation Health Plan Inc
Kaiser Health Plan Mob 2 Phy 686 is an health care organization with primary practice located at 7373 West Ln Fl 2 , Stockton CA 95210-3377. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Kaiser Foundation Health Plan Inc can be contacted via phone (209) 476-3105, or through Brown, Kathryn Renouard via phone (510) 625-2363.

Contact Information

Primary practice address
7373 West Ln Fl 2 Stockton CA 95210-3377
Phone: (209) 476-3105
Fax: (209) 476-3074
Website:
Map and Directions
Authorized official contact:
Name: Brown, Kathryn Renouard
Phone: (510) 625-2363

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHY37510 California

Profile Details

NPI number 1760530406
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Health Plan Mob 2 Phy 686
Authorized official Brown, Kathryn Renouard
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2007
Last updated Oct 19th, 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 1760530406 NPPES
Other 0554774 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID PHA375100 NCPDP PROVIDER IDENTIFICATION NUMBER

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