MODESTO VA CLINIC (612GM) (4604) INSTITUTION (4)

Name	Value
NAME	MODESTO VA CLINIC (612GM)
STATE	CALIFORNIA
STREET ADDR. 1	1225 OAKDALE RD
CITY	MODESTO
ZIP	95355-3357
OFFICIAL VA NAME	MODESTO VA CLINIC (612GM)
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 21 PARENT FACILITY PARENT OF ASSOCIATION: NORTHERN CALIFORNIA HCS
BILLING FACILITY NAME	MODESTO VA CLINIC
EFFECTIVE DATE/TIME	2022-10-27 00:00:00 STATUS: ACTIVE NPI: 1780301713
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	PACIFIC
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	612GM
HISTORY