Provider Demographics
NPI:1275785735
Name:VETERANS ADMINISTRATION PALO ALTO HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:VETERANS ADMINISTRATION PALO ALTO HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:1650-493-5000
Mailing Address - Street 1:3801 MIRANDA AVE
Mailing Address - Street 2:PROSTHETICS/121
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1207
Mailing Address - Country:US
Mailing Address - Phone:650-493-5000
Mailing Address - Fax:650-852-3267
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:PROSTHETICS/121
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-852-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty