Provider Demographics
NPI:1962289686
Name:KAISER FOUNDATION HEALTH PLAN INC
Entity type:Organization
Organization Name:KAISER FOUNDATION HEALTH PLAN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, AMBULATORY CARE & CLINICAL SVCS
Authorized Official - Prefix:
Authorized Official - First Name:DIONICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAGAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-282-9989
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:808-432-5245
Mailing Address - Fax:
Practice Address - Street 1:80 MAHALANI ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2531
Practice Address - Country:US
Practice Address - Phone:833-833-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAISER FOUNDATION HEALTH PLAN INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory