Provider Demographics
NPI:1346414661
Name:DEPARTMENT OF VETERANS ARRAIRS
Entity Type:Organization
Organization Name:DEPARTMENT OF VETERANS ARRAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FREUDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-939-9327
Mailing Address - Street 1:6344 AGNES AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6344 AGNES AVE
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3304
Practice Address - Country:US
Practice Address - Phone:818-939-9327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653992282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital