Kaiser Health Plan Mob Phy 401

LBN: Kaiser Foundation Health Plan Inc
Kaiser Health Plan Mob Phy 401 is an health care organization with primary practice located at 1550 Gateway Blvd , Fairfield CA 94533-6901. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Inc can be contacted via phone (707) 427-4222, or through Brown, Kathryn Renouard via phone (510) 625-2363.

Contact Information

Primary practice address
1550 Gateway Blvd Fairfield CA 94533-6901
Fax: (707) 427-4215
Website:
Authorized official contact:
Name: Brown, Kathryn Renouard

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY43294 California

Profile Details

NPI number 1942357264
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Health Plan Mob Phy 401
Authorized official Brown, Kathryn Renouard
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2007
Last updated Oct 22nd, 2020 - about 5 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 1942357264 NPPES
Other 0552542 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID PHA432940 NCPDP PROVIDER IDENTIFICATION NUMBER

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