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KAISER FOUNDATION HEALTH PLAN INC NPI 1962568238


NPI Information

NPI: 1962568238
Provider Name: KAISER FOUNDATION HEALTH PLAN INC

Doing Business As: KAISER PERMANENTE PHARMACY #162

Classification: Pharmacy - 3336C0004X
Entity Type: Organization

Specialization: Compounding Pharmacy

CLIA Number: 05D0573387

Address:
9961 SIERRA AVE
MOB 3 BASEMENT RM#1-B800
FONTANA, CA
ZIP 92335
Phone: (909) 427-4941
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KAISER FOUNDATION HEALTH PLAN INC is a compounding pharmacy pharmacy in Fontana, CA. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. KAISER FOUNDATION HEALTH PLAN INC NPI is 1962568238. The provider is registered as an organization entity type.
The provider Is Doing Business As Kaiser Permanente Pharmacy #162.

The provider's business location address is:

9961 SIERRA AVE
MOB 3 BASEMENT RM#1-B800
FONTANA, CA
ZIP 92335-720
Phone: (909) 427-4941

The provider's authorized official is Alan Kiyohara .
The authorized official title is Vp Pharmacy Operations & Svcs, Scal and has the following contact phone number (562) 658-3510.

The CLIA number assigned to this NPI record is 05D0573387 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 8/7/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0004XPharmacyCompounding PharmacyPHY47314CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12111836OTHERPK
25624754OTHERCALIFORNIANCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.