| NAME |
PLACENTIA VA CLINIC |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
770 S PLACENTIA AVE |
| CITY |
PLACENTIA |
| ZIP |
92870-6832 |
| OFFICIAL VA NAME |
PLACENTIA VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PLACENTIA VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1699726851
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
600GA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 2569 W. WOODLAND DR
- CITY (CHANGED FROM): ANAHEIM
- STATE (CHANGED FROM): CALIFORNIA
- ZIP (CHANGED FROM): 92801-2608
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1699726851
-
- CODING SYSTEM: VASTANUM
- ID: 600GA
-
- CODING SYSTEM: CLIA
- ID: 05D1054521
|
