KAISER FOUNDATION HEALTH PLAN INC NPI 1962568238

NPI Information

  • NPI: 1962568238
  • Provider Name: KAISER FOUNDATION HEALTH PLAN INC
  • Classification: Pharmacy - 3336C0004X
  • Specialization: Compounding Pharmacy
  • Entity Type: Organization
  • Other Name: KAISER PERMANENTE PHARMACY #162
  • CLIA Number: 05D0909202
  • Address: 9961 SIERRA AVE
    MOB 3 BASEMENT RM#1-B800
    FONTANA, CA
    ZIP 92335
  • Phone: (909) 427-4941

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NPI Details

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 Other Name Is 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 Rhonda Lee Polchak .
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 05D0909202 - health main. organization with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 6/13/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15624754OTHERCALIFORNIANCPDP
22111836OTHERPK

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: 11/21/2025

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