| NAME |
MCCLELLAN VA CLINIC |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
5342 DUDLEY BLVD, BUILDING 88 |
| CITY |
MCCLELLAN |
| ZIP |
95652-1012 |
| OFFICIAL VA NAME |
MCCLELLAN VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
MCCLELLAN VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1225071756
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
612GH |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1225071756
-
- CODING SYSTEM: VASTANUM
- ID: 612GH
-
- CODING SYSTEM: CLIA
- ID: 05D0988247
|
