Provider Demographics
NPI:1114026663
Name:VA GREATER LOS ANGELES HEALTHCARE SYSTEM, WEST LOS ANGELES126
Entity Type:Organization
Organization Name:VA GREATER LOS ANGELES HEALTHCARE SYSTEM, WEST LOS ANGELES126
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DSC
Authorized Official - Phone:310-268-3923
Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:BUILDING 113, ROOM 324
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-268-3924
Mailing Address - Fax:310-312-9478
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:BUILDING 113, ROOM 324
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-3924
Practice Address - Fax:310-312-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054208261QV0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA