ZZ-OAKLAND VA CLINIC (290)    INSTITUTION (4)

Name Value
NAME ZZ-OAKLAND VA CLINIC
STATE CALIFORNIA
STREET ADDR. 1 2221 MARTIN LUTHER KING JR. WAY
CITY OAKLAND
ZIP 94612-1318
OFFICIAL VA NAME OAKLAND VA CLINIC
INACTIVE FACILITY FLAG INACTIVE
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME OAKLAND VA CBOC
ST. ADDR. 1 (MAILING) 2221 MARTIN LUTHER KING JR. WAY
CITY (MAILING) OAKLAND
STATE (MAILING) CALIFORNIA
ZIP (MAILING) 94612-1318
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1023058609
  • 2022-02-10 00:00:00
    STATUS:   INACTIVE
    NPI:   1023058609
TAXONOMY CODE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 612BY
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1023058609
  • CODING SYSTEM:   VASTANUM
    ID:   612BY
  • CODING SYSTEM:   CLIA
    ID:   05D0988246