KAISER FOUNDATION HEALTH PLAN INC (NPI# 1932257565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932257565 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN INC |
| Other Organization Name | KAISER PERMANENTE PHARMACY #864 |
| Practice Address |
79 440 Corporate Centre Suite 106 La Quinta CA 92553 |
| Mailing Address |
12254 Bellflower Blvd Fl 2 Pharmacy Professional Affairs Downey CA 90242-2804 |
| Practice Telephone | 7607716446 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-05-18 |
| Authorized Official Name | DAVID KVANCZ (VP NAT'L PHRMCY PROG & SVCS) |
| Authorized Official Telephone | 5626583510 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY46155 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 0558518 | 01 | |
| CA | PHA461550 | 05 |
| Other Name | Type Code |
|---|---|
| KAISER PERMANENTE PHARMACY #864 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| 1942820485 | Kaiser Foundation Health Plan Inc | Pharmacy | 5300 Mcconnell Ave Fl 1, Rm 1150, Los Angeles, CA 90066-7026 | 2020-04-24 |
| 1720607112 | Kaiser Foundation Health Plan Inc | Pharmacy | 6911 Convoy Ct Fl 1 Rm 1501, San Diego, CA 92111-1014 | 2020-04-15 |
| 1114568698 | Kaiser Foundation Health Plan Inc | Pharmacy | 7007 Romaine St, Los Angeles, CA 90038 | 2019-10-04 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1437618105 | Kaiser Foundation Health Plan Inc | Pharmacy | 12761 Schabarum Ave Plaza Level Rm 1100, Irwindale, CA 91706-6807 | 2019-03-13 |
| 1336607506 | Kaiser Foundation Health Plan Inc | Pharmacy | 3100 Dublin Blvd Fl 1, Dublin, CA 94568-4363 | 2019-03-06 |
| 1073085007 | Kaiser Foundation Health Plan Inc | Pharmacy | 615 W Avenue L Trailer, Lancaster, CA 93534-7211 | 2019-01-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | KAISER FOUNDATION HEALTH PLAN INC. | 1 Kaiser Plz, Oakland, California 94612-3610 |
| Street Address |
79 440 CORPORATE CENTRE SUITE 106 |
| City | LA QUINTA |
| State | CA |
| Zip Code | 92553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104441559 | Tanya Gentle | Marriage & Family Therapist | 2319 Cottonwood Avenue, Building A Suite 110, Moreno Valley, CA 92553 | 2020-06-11 |
| 1275194227 | Antonio Pearce | Psychologist | 12968 Frederick Street, Suite D, Moreno Valley, CA 92553 | 2019-06-20 |
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1952813420 | Shanaya Frederick | Driver | 14929 Spinnaker Lane, Moreno Valley, CA 92553 | 2017-10-24 |
| 1457879413 | R & C Logistic Services, LLC | Private Vehicle | 14768 Briana St, Moreno Valley, CA 92553 | 2017-08-30 |
| 1720505084 | Elda Pricila Hernandez | Behavioral Analyst | 24596 Atwood Ave.apt1, Moreno Valley, CA 92553 | 2017-08-28 |
| 1174044101 | Ps Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 24594 Sunnymead Blvd, Suite M, Moreno Valley, CA 92553 | 2017-06-29 |
| 1942736327 | Richard Pantoja Reyna | Licensed Vocational Nurse | 23119 Cottonwood Ave Bld A Suite 110, Moreno Valley, CA 92553 | 2017-05-04 |
| 1255872719 | Sibonisiwe Moyo Johnson | Nurse Practitioner | 22555 Alessandro Blvd Ste B, Moreno Valley, CA 92553 | 2017-03-16 |
| 1518311190 | Ryan Macavinta | Nurse Practitioner | 22765 Alessandro Blvd., Moreno Valley, CA 92553 | 2016-04-20 |
| Find all providers in zip 92553 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164505202 | Costco Wholesale Corporation | Pharmacy | 79795 Highway 111, La Quinta, CA 92253-4756 | 2006-10-23 |
| 1083617740 | La Quinta Pharmacy | Pharmacy | 78150 Calle Tampico, Ste 103, La Quinta, CA 92253-2907 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.