1144375056 NPI number — KAISER FOUNDATION HOSPITALS

Table of content: (NPI 1144375056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144375056 NPI number — KAISER FOUNDATION HOSPITALS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAISER FOUNDATION HOSPITALS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144375056
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3440 E. LA PALMA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92806-2020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-644-2000
Provider Business Mailing Address Fax Number:
714-644-4114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3440 E. LA PALMA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92806-2020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-644-2000
Provider Business Practice Location Address Fax Number:
714-644-4114
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COSTA
Authorized Official First Name:
MARK
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SVP AREA MANAGER
Authorized Official Telephone Number:
714-644-4100

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  060000091 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 339040902 . This is a "USDOL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZT40609G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50609 . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 050609B000000 . This is a "DHS SECTION 1011" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZT30609G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZZV3011Z . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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