KAISER FOUNDATION HEALTH PLAN INC
1721 W Yosemite Ave
Manteca, CA 95337
209-824-5078
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy | CA | PHY43518 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
PHA435180 | CA | MEDICAID | |
NCPDP PROVIDER IDENTIFICATION NUMBER | 0500353 | OTHER |