Provider Demographics
NPI:1326131939
Name:VETERANS ADMINISTRATION MEDICAL CENTER
Entity Type:Organization
Organization Name:VETERANS ADMINISTRATION MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF INTERNIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:GONZAGA
Authorized Official - Last Name:ALMARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-825-7084
Mailing Address - Street 1:11201 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92357
Mailing Address - Country:US
Mailing Address - Phone:909-825-7084
Mailing Address - Fax:909-777-3295
Practice Address - Street 1:11201 BENTON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH359194-G282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital