Provider Demographics
NPI:1164577979
Name:KAISER FOUNDATION HOSPITALS
Entity Type:Organization
Organization Name:KAISER FOUNDATION HOSPITALS
Other - Org Name:KAISER FOUNDATION HOSPITAL LOS ANGELES - HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP/AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:GRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-783-8100
Mailing Address - Street 1:3100 THORNTON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3183
Mailing Address - Country:US
Mailing Address - Phone:818-557-6800
Mailing Address - Fax:818-557-7168
Practice Address - Street 1:3100 THORNTON AVE STE 105
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-3183
Practice Address - Country:US
Practice Address - Phone:818-557-6800
Practice Address - Fax:818-557-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000510251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01525FMedicaid
CAHPC01525FMedicaid