Healthcare Provider Details

I. General information

NPI: 1003918129
Provider Name (Legal Business Name): VA MEDICAL CENTER,WASHINGTON,D.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8113
  • Fax:
Mailing address:
  • Phone: 202-745-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number741
License Number StateDC

VIII. Authorized Official

Name: DR. DAVID RINDLER
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 202-745-8113