Organization · Type 2 NPI

Kaiser Foundation Health Plan Inc

Community/Retail Pharmacy · San Juan Capistrano, CA

NPI number 1770630097 Active

Practice location

30400 Camino Capistrano
San Juan Capistrano, CA 92675-1300

Call (866) 353-5054 Map

Mailing address

12254 Bellflower Blvd Fl 2, Pharmacy Operations
Downey, CA 90242-2804

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PHY44554 (CA)

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 …

10 other providers at this address

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NPI record

NPI: 1770630097
Entity type: Organization (Type 2)
Issued: Jan 5, 2007
Last updated: Jun 23, 2023
Status: Active

Other names

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Kaiser Permanente Pharmacy No 391 · doing business as
Kaiser Permanente Pharmacy No 391 · doing business as

Authorized official

Rhonda Lee Polchak
VP Pharmacy Operations & Svcs, Scal
(562) 658-3510

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1770630097

Kaiser Foundation Health Plan Inc's National Provider Identifier is 1770630097, issued on Jan 5, 2007. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in San Juan Capistrano, CA. The record was last updated on Jun 23, 2023.