Provider Demographics
NPI:1588743181
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/AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-851-4120
Mailing Address - Street 1:3900 FREEDOM CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-1222
Mailing Address - Country:US
Mailing Address - Phone:408-235-4000
Mailing Address - Fax:408-235-4055
Practice Address - Street 1:3900 FREEDOM CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-1222
Practice Address - Country:US
Practice Address - Phone:408-235-4000
Practice Address - Fax:408-235-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000406251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
557066Medicare Oscar/Certification