Provider Demographics
NPI:1801960513
Name:KAISER FOUNDATION HOSPITALS
Entity type:Organization
Organization Name:KAISER FOUNDATION HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP/AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-784-4355
Mailing Address - Street 1:39400 PASEO PADRE PKWY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2310
Mailing Address - Country:US
Mailing Address - Phone:510-248-3000
Mailing Address - Fax:
Practice Address - Street 1:39400 PASEO PADRE PKWY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2310
Practice Address - Country:US
Practice Address - Phone:510-248-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000053282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA339040917OtherUSDOL
CAZZZC0109ZOtherBLUE SHIELD OF CA
CA50512OtherBLUE CROSS OF CA
CAHSP40512FMedicaid
CAZZR00512FMedicaid
CA050512B000000OtherSECTION 1011-DHS
CAHSP40512FMedicaid
CAZZR00512FMedicaid
CA339040917OtherUSDOL
CA50512OtherBLUE CROSS OF CA
CAZZZ83468ZMedicare ID - Type UnspecifiedMEDICARE - NHIC