Provider Demographics
NPI:1114037017
Name:VA GREATER LOS ANGELES HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:VA GREATER LOS ANGELES HEALTH CARE SYSTEM
Other - Org Name:NA
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR, WOMEN'S HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:FATMA
Authorized Official - Middle Name:KHAWAJA
Authorized Official - Last Name:BATUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-478-3711
Mailing Address - Street 1:11301 WILSHIRE BLVD BLDG 500 ROOM 3209
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-478-3711
Mailing Address - Fax:310-268-4086
Practice Address - Street 1:16820 EDGAR ST
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3227
Practice Address - Country:US
Practice Address - Phone:310-459-2597
Practice Address - Fax:310-268-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51537261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health