Provider Demographics
NPI: | 1396813861 |
---|---|
Name: | KAISER FOUNDATION HOSPITALS |
Entity type: | Organization |
Organization Name: | KAISER FOUNDATION HOSPITALS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DANIEL |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | SHAW |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 808-432-5272 |
Mailing Address - Street 1: | 711 KAPIOLANI BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | HONOLULU |
Mailing Address - State: | HI |
Mailing Address - Zip Code: | 96813-5237 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 808-432-5276 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3288 MOANALUA RD |
Practice Address - Street 2: | |
Practice Address - City: | HONOLULU |
Practice Address - State: | HI |
Practice Address - Zip Code: | 96819-1469 |
Practice Address - Country: | US |
Practice Address - Phone: | 808-432-0000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-01 |
Last Update Date: | 2021-04-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
HI | 08252101 | Medicaid | |
HI | 120011 | Medicare Oscar/Certification |