| NPI | 1689721904 |
|---|---|
| Doing Business As | KAISER HEALTH PLAN MODESTO PHY |
| Entity Type | Organization |
| Authorized Contact | LYNN RILEY Op Pharmacy Mgr 209-557-1146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: CA PHY41599) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |