Provider Demographics
NPI:1013062769
Name:KAISER FOUNDATION HOSPITALS
Entity Type:Organization
Organization Name:KAISER FOUNDATION HOSPITALS
Other - Org Name:KAISER FOUNDATION HOSPITAL SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-528-3390
Mailing Address - Street 1:4647 ZION AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2507
Mailing Address - Country:US
Mailing Address - Phone:619-528-5000
Mailing Address - Fax:619-528-5317
Practice Address - Street 1:9455 CLAIREMONT MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1297
Practice Address - Country:US
Practice Address - Phone:619-528-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000062282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050515B000000OtherDHS SECTION 1011
CA341704400OtherUSDOL
CAZZT30515FMedicaid
CAZZT40515FMedicaid
CA50515OtherBLUE CROSS
CAZZZA3700ZOtherBLUE SHIELD
CAZZT40515FMedicaid
CA050515B000000OtherDHS SECTION 1011
CAW1871Medicare ID - Type UnspecifiedNHIC