GREATER LA VA MOBILE CLINIC (4666) INSTITUTION (4)

Name	Value
NAME	GREATER LA VA MOBILE CLINIC
STATE	CALIFORNIA
STREET ADDR. 1	11301 WILSHIRE BLVD
CITY	LOS ANGELES
ZIP	90073-1003
OFFICIAL VA NAME	GREATER LA VA MOBILE CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 22 PARENT FACILITY PARENT OF ASSOCIATION: WEST LA VAMC
BILLING FACILITY NAME	LOS ANGELES VA MOBILE CLINIC
EFFECTIVE DATE/TIME	2023-09-27 00:00:00 STATUS: ACTIVE NPI: 1518746791
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	691QA
HISTORY