| NAME |
ZZ-MODESTO VA CLINIC |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
1225 OAKDALE ROAD |
| CITY |
MODESTO |
| ZIP |
95335-3357 |
| OFFICIAL VA NAME |
MODESTO VA CLINIC (640HB) |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
MODESTO VA CBOC |
| ST. ADDR. 1 (MAILING) |
1225 OAKDALE ROAD |
| CITY (MAILING) |
MODESTO |
| STATE (MAILING) |
CALIFORNIA |
| ZIP (MAILING) |
95335-3357 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: INACTIVE
- NPI: 1649218322
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
640HB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1649218322
-
- CODING SYSTEM: VASTANUM
- ID: 640HB
-
- CODING SYSTEM: CLIA
- ID: 05D1043396
|
