KAISER PERMANENTE PHARMACY #397
NPI 1093192577
Pharmacy - Compounding Pharmacy in San Rafael, CA
NPI Status: Active since May 04, 2015
Contact Information
99 MONTECILLO RD
BLDG 2 FL-5 RM 5254
SAN RAFAEL, CA
ZIP 94903
Phone: (415) 444-2319
- Organization
- Pharmacy
- Compounding Pharmacy
- CLIA Number: 05D0688085
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2026
About KAISER PERMANENTE PHARMACY #397
This page provides the complete NPI Profile along with additional information for Kaiser Permanente Pharmacy #397, a provider established in San Rafael, California operating as a Pharmacy, focusing in compounding pharmacy . The healthcare provider is registered in the NPI registry with number 1093192577 assigned on May 2015. The practitioner's primary taxonomy code is 3336C0004X with license number PHY52494 (CA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's other name is Kaiser Permanente Pharmacy #397. The authorized official of this NPI record is William Perry Flowers (Vp Acute Transitional Care)
- NPI
- 1093192577
- Provider Legal Name
- KAISER FOUNDATION HEALTH PLAN INC
- Other Organization Name
- KAISER PERMANENTE PHARMACY #397
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 99 MONTECILLO RD BLDG 2 FL-5 RM 5254 SAN RAFAEL, CA 94903
- Location Phone
- (415) 444-2319
- Mailing Address
- 99 MONTECILLO RD BLDG 2 FL-5 RM 5254 SAN RAFAEL, CA 94903
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-04-2015
- Last Update Date
- 06-01-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Compounding Pharmacy
- Taxonomy Code
- 3336C0004X
- Type
- Suppliers
- License No.
- PHY52494
- License State
- CA
- Taxonomy Description
- A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 333600000X | Suppliers | Pharmacy | PHY52494 (CA) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0688085
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- JENNY DONG
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kaiser Permanente Pharmacy #397 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1093192577, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SAN RAFAEL, CA 94903
SAN RAFAEL, CA 94903
SAN RAFAEL, CA 94903
SAN RAFAEL, CA 94903
SAN RAFAEL, CA 94903
SAN RAFAEL, CA 94903
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093192577, enumerated as an "organization" on May 04, 2015.
The provider is located at 99 MONTECILLO RD BLDG 2 FL-5 RM 5254 SAN RAFAEL, CA 94903 and the phone number is (415) 444-2319.
Pharmacy with taxonomy code 3336C0004X and a focus in Compounding Pharmacy.
