Provider Demographics
NPI:1649559386
Name:KAISER DOWNEY MEDICAL CENTER
Entity Type:Organization
Organization Name:KAISER DOWNEY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ODEGARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:562-657-9003
Mailing Address - Street 1:9333 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2812
Mailing Address - Country:US
Mailing Address - Phone:562-657-9005
Mailing Address - Fax:
Practice Address - Street 1:9333 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2812
Practice Address - Country:US
Practice Address - Phone:562-657-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58585282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital