Provider Demographics
NPI:1386799286
Name:KAISER FOUNDATION HOSPITALS
Entity type:Organization
Organization Name:KAISER FOUNDATION HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-375-2131
Mailing Address - Street 1:10605 BALBOA BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6342
Mailing Address - Country:US
Mailing Address - Phone:818-832-7422
Mailing Address - Fax:818-832-7253
Practice Address - Street 1:10605 BALBOA BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6342
Practice Address - Country:US
Practice Address - Phone:818-832-7422
Practice Address - Fax:818-832-7253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000511251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01521FMedicaid
CAHPC01521FMedicaid