Healthcare Provider Details

I. General information

NPI: 1760587562
Provider Name (Legal Business Name): VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111201 BENTON STREET
LOMA LINDA CA
92354
US

IV. Provider business mailing address

24225 KHAN DR
LOMA LINDA CA
92354-4877
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax: 909-777-3837
Mailing address:
  • Phone: 909-825-7084
  • Fax: 909-777-3834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberA50535
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberA 50535
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License NumberA50535
License Number StateCA

VIII. Authorized Official

Name: MALWINDER KAUR MULTANI
Title or Position: STAFF PHYSICIAN
Credential: M.D
Phone: 909-825-7084