Provider Demographics
NPI:1952476665
Name:KAISER FOUNDATION HOSPITALS
Entity Type:Organization
Organization Name:KAISER FOUNDATION HOSPITALS
Other - Org Name:KAISER FOUNDATION HOSPITAL SACRAMENTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-973-6045
Mailing Address - Street 1:2025 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2115
Mailing Address - Country:US
Mailing Address - Phone:916-973-5000
Mailing Address - Fax:
Practice Address - Street 1:2025 MORSE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2115
Practice Address - Country:US
Practice Address - Phone:916-973-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000052282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA339040921OtherUSDOL
CA339040920OtherUSDOL
CA50425OtherBLUE CROSS OF CA
CAHSP40425FMedicaid
CAZZR00425FMedicaid
CA050425B000000OtherSECTION 1011-DHS
CAZZZA3404ZOtherBLUE SHIELD OF CA
CAZZR00425FMedicaid
CA50425OtherBLUE CROSS OF CA
CA339040921OtherUSDOL
CA50425OtherBLUE CROSS OF CA
CAZZZ20738ZMedicare ID - Type UnspecifiedMEDICARE - NHIC