| NAME |
GARDENA CBOC (691GC) |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
1149 W 190TH STREET, 1ST FLOOR |
| CITY |
GARDENA |
| ZIP |
90248-4321 |
| OFFICIAL VA NAME |
GARDENA CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GARDENA VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1780638254
-
- 2020-12-30 00:00:00
- STATUS: INACTIVE
- NPI: 1780638254
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
691GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1780638254
-
- CODING SYSTEM: VASTANUM
- ID: 691GC
|
