MEDICARE: VA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	530823	CA

General Provider Information

NPI Number	:	1831434190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VA

Provider Business Mailing Address
First Line	:	2701 SEQUOIA CREEK DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-3209
Country	:	US
Telephone Number	:	408-476-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 SEQUOIA CREEK DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-3209
Country	:	US
Telephone Number	:	408-476-9999
Fax Number	:

Authorized Official
Title or Position	:	RN
Name	:	PAULA LUONG
Credential	:	BSN
Telephone Number	:	408-476-9999

Provider Enumeration Date	:	11/27/2012
Last Update Date	:	11/27/2012

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Directions to “VA ” Practice Location

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