| NAME |
SEPULVEDA VAMC |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
16111 PLUMMER ST |
| CITY |
SEPULVEDA |
| ZIP |
91343-2036 |
| OFFICIAL VA NAME |
SEPULVEDA OUTPATIENT & NURSING HOME CARE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SEPULVEDA VA CBOC |
| ST. ADDR. 1 (MAILING) |
16111 PLUMMER ST |
| CITY (MAILING) |
SEPULVEDA |
| STATE (MAILING) |
CALIFORNIA |
| ZIP (MAILING) |
91343-2036 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1285676387
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
691A4 |
| HISTORY |
-
- EFFECTIVE DATE: 1998-10-01 00:00:00
- REALIGNED FROM: ZZ SEPULVEDA
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1285676387
-
- CODING SYSTEM: VASTANUM
- ID: 691A4
-
- CODING SYSTEM: CLIA
- ID: 05D0988216
|
