Provider Demographics
NPI:1427123132
Name:KAISER FOUNDATION HOSPITALS
Entity type:Organization
Organization Name:KAISER FOUNDATION HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:FRATZKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-752-2972
Mailing Address - Street 1:275 W MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5641
Mailing Address - Country:US
Mailing Address - Phone:510-752-1000
Mailing Address - Fax:
Practice Address - Street 1:280 W MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5642
Practice Address - Country:US
Practice Address - Phone:510-752-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000052282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA339040918OtherUSDOL
CA50075OtherBLUE CROSS OF CA
CA050075B000000OtherSECTION 1011-DHS
CAZZZC0109ZOtherBLUE SHIELD OF CA
CAHSP40074FMedicaid
CAZZR00074FMedicaid
CAHSP40075FMedicaid
CAZZR00075FMedicaid
CAZZZA0104ZOtherBLUE SHIELD OF CA
CA339040922OtherUSDOL
CAZZZC0109ZOtherBLUE SHIELD OF CA
CAZZR00075FMedicaid
CA339040922OtherUSDOL
CAHSP40074FMedicaid
CA050075B000000OtherSECTION 1011-DHS