Provider Demographics
NPI:1760678403
Name:KAISER PERMANENTE
Entity Type:Organization
Organization Name:KAISER PERMANENTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIETITIAN II
Authorized Official - Prefix:MS
Authorized Official - First Name:AYODEJI
Authorized Official - Middle Name:A
Authorized Official - Last Name:OLADUNJOYE
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD
Authorized Official - Phone:619-944-9838
Mailing Address - Street 1:32901 MIRA ST
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7856
Mailing Address - Country:US
Mailing Address - Phone:619-944-9838
Mailing Address - Fax:
Practice Address - Street 1:32901 MIRA ST
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-7856
Practice Address - Country:US
Practice Address - Phone:619-944-9838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital