| NAME |
SANTA ROSA, CA CBOC |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
2285 CHALLENGER WAY |
| CITY |
SANTA ROSA |
| ZIP |
95407-9998 |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SANTA ROSA VA CLINIC |
| ST. ADDR. 1 (MAILING) |
2285 CHALLENGER WAY |
| CITY (MAILING) |
SANTA ROSA |
| STATE (MAILING) |
CALIFORNIA |
| ZIP (MAILING) |
95407-9998 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1366480469
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
662GA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 3841 BRICKWAY BLVD
- CITY (CHANGED FROM): SANTA ROSA
- STATE (CHANGED FROM): CALIFORNIA
- ZIP (CHANGED FROM): 95403-8226
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1366480469
-
- CODING SYSTEM: VASTANUM
- ID: 662GA
|
