| NAME |
ALICE |
| STATE |
TEXAS |
| STREET ADDR. 1 |
102 E KING, SUITE 200 |
| CITY |
SAN DIEGO |
| ZIP |
78384-1838 |
| OFFICIAL VA NAME |
CHRISTUS SPOHN SAN DIEGO FAMILY HEALTH CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SAN DIEGO VA CBOC |
| ST. ADDR. 1 (MAILING) |
102 E KING, SUITE 200 |
| CITY (MAILING) |
SAN DIEGO |
| STATE (MAILING) |
TEXAS |
| ZIP (MAILING) |
78384-1838 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: INACTIVE
- NPI: 1164473385
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
OTHER |
| POINTER TO AGENCY |
OTHER |
| STATION NUMBER |
671GG |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1164473385
-
- CODING SYSTEM: VASTANUM
- ID: 671GG
-
- CODING SYSTEM: CLIA
- ID: 45D0910461
|
