MEDICARE: WLA GREATER LOS ANGELES VAMC

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

General Provider Information

NPI Number	:	1053420125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WLA GREATER LOS ANGELES VAMC

Provider Business Mailing Address
First Line	:	2505 4TH ST
Second Line	:	APT 204
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3623
Country	:	US
Telephone Number	:	310-314-9798
Fax Number	:

Provider Business Practice Location Address
First Line	:	2505 4TH ST
Second Line	:	APT 204
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3623
Country	:	US
Telephone Number	:	310-314-9798
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIETITIAN
Name	:	DR. SEVIM F LOKER
Credential	:	PHD
Telephone Number	:	310-478-3711

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/22/2020

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