KAISER FOUNDATION HEALTH PLAN INC (NPI# 1093192577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093192577 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN INC |
| Other Organization Name | KAISER PERMANENTE PHARMACY #397 |
| Practice Address |
99 Montecillo Rd Bldg 2 Fl-5 Rm 5254 San Rafael CA 94903 |
| Mailing Address |
99 Montecillo Rd Bldg 2 Fl-5 Rm 5254 San Rafael CA 94903-3308 |
| Practice Telephone | 4154442319 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2018-06-01 |
| Authorized Official Name | WILLIAM PERRY FLOWERS (VP ACUTE TRANSITIONAL CARE) |
| Authorized Official Telephone | 5626583510 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PHY52494 | CA | Suppliers |
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHY52494 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Pharmacy #397 | Other Name - Individual/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 |
99 MONTECILLO RD BLDG 2 FL-5 RM 5254 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528889 | Jeffry D Cardneau | Surgery | 99 Montecillo Rd, Mob 1, 2nd Floor, Department of Surgery, San Rafael, CA 94903-3308 | 2005-06-17 |
| 1225645468 | Lauren Freudman | Occupational Therapist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-09-30 |
| 1285254037 | Omar Ahmed | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-04-22 |
| 1447887229 | Meka Angela Parks | Registered Nurse | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-03-24 |
| 1710519202 | Mahsa Khorramdin | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-02-12 |
| 1568001071 | Jessica Tan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-31 |
| 1720626211 | Ava May Mahan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-15 |
| 1437797271 | Alicia Pontecorvo | Dietitian, Registered | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-11 |
| 1437795499 | Shirley Liu | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-11-25 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| 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. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881099018 | Ross Valley Compounding Pharmacy, Inc. | Pharmacy | 1525 Francisco Blvd E, Ste 1, San Rafael, CA 94901-5539 | 2014-10-30 |
| 1063575694 | Benson Toy | Pharmacy | 750 Las Gallinas Ave, Ste 104, San Rafael, CA 94903-3438 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609496215 | Kaiser Foundation Hospitals | Pharmacy | 274 International Cir Fl 1 Rm 104, San Jose, CA 95119 | 2020-04-23 |
| 1093278236 | Gold Country Compounding LLC | Pharmacy | 11990 Heritage Oak Pl Ste 2c, Auburn, CA 95603-2405 | 2019-04-12 |
| 1669935177 | Creative Care-rx, Inc. | Pharmacy | 3303 Harbor Blvd Ste C4, Costa Mesa, CA 92626-1518 | 2019-04-11 |
| 1396204095 | Nordahl Pharmacy Corp | Pharmacy | 740 Nordahl Rd Ste 120, San Marcos, CA 92069-3545 | 2019-03-13 |
| 1104329820 | Oz Med, Inc. | Pharmacy | 44150 Town Center Way, Ste B4, Palm Desert, CA 92260 | 2018-03-09 |
| 1639688732 | Cure Stat Rx Home Infusion and Specialty Pharmacy Inc | Pharmacy | 6725 Mesa Ridge Rd Ste 202&230, San Diego, CA 92121-2923 | 2017-09-21 |
| 1770010068 | Onesource Compounding Pharmacy | Pharmacy | 104 Whispering Pines Dr Ste 105, Scotts Valley, CA 95066 | 2017-05-17 |
| 1326498619 | Preferred Pharmacy Inc | Pharmacy | 3303 Harbor Blvd Ste H7, Costa Mesa, CA 92626-1523 | 2016-06-16 |
| 1720449267 | Hot Springs Pharmacy Inc | Pharmacy | 13313 Palm Dr Ste A, Desert Hot Springs, CA 92240-5980 | 2016-03-11 |
| 1447619432 | Qps Pharmacy Inc | Pharmacy | 18502 Beach Blvd, Suite 116, Huntington Beach, CA 92648-2019 | 2016-02-18 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on KAISER FOUNDATION HEALTH PLAN INC.
| 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.