ZZ-TWENTY FIRST STREET VA CL (3761)    INSTITUTION (4)

Name Value
NAME ZZ-TWENTY FIRST STREET VA CL
STATE CALIFORNIA
STREET ADDR. 1 525 21ST STREET
CITY OAKLAND
ZIP 94612-1605
OFFICIAL VA NAME TWENTY FIRST STREET VA CLINIC
INACTIVE FACILITY FLAG INACTIVE
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME TWENTY FIRST STREET VA OOS
EFFECTIVE DATE/TIME
  • 2014-10-01 00:00:00
    STATUS:   ACTIVE
    NPI:   1972995306
  • 2022-02-10 00:00:00
    STATUS:   INACTIVE
    NPI:   1972995306
TAXONOMY CODE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 612QB