KAISER FOUNDATION HEALTH PLAN INC
975 Sereno Dr Fl 2
Vallejo, CA 94589
707-651-3443
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy | CA | PHY37049 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
PHA370490 | CA | MEDICAID | |
NCPDP PROVIDER IDENTIFICATION NUMBER | 0552768 | OTHER |