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NPI Code Detail

MEDICARE: PALO ALTO VAMC

MEDICARE: PALO ALTO 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
1261QV0200XVA Clinic/Center

General Provider Information

NPI Number : 1134162688
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALO ALTO VAMC
Provider Business Mailing Address
First Line : PO BOX 94415
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4415
Country : US
Telephone Number : 702-341-3020
Fax Number :
Provider Business Practice Location Address
First Line : 201 9TH ST
Second Line :
City : MARINA
State : CA
Zip : 93933-6039
Country : US
Telephone Number : 702-341-3020
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 06/13/2006
Last Update Date : 04/18/2019

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Directions to “PALO ALTO VAMC ” Practice Location

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