Provider Demographics
NPI:1245407618
Name:VAHEALTHCARESYSYEM
Entity Type:Organization
Organization Name:VAHEALTHCARESYSYEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:CABILING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-552-8585
Mailing Address - Street 1:17111 ALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-7820
Mailing Address - Country:US
Mailing Address - Phone:858-673-4510
Mailing Address - Fax:858-673-4510
Practice Address - Street 1:VA MEDICAL CENTER 3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0001
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN601024282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital