Provider Demographics
NPI:1265462576
Name:VA SANDIEGO HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:VA SANDIEGO HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SC I STAFF
Authorized Official - Prefix:DR
Authorized Official - First Name:FAHIMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NASAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-642-7842
Mailing Address - Street 1:11232 VISTA SORRENTO PKWY
Mailing Address - Street 2:APT102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-7625
Mailing Address - Country:US
Mailing Address - Phone:858-345-7401
Mailing Address - Fax:
Practice Address - Street 1:VA SANDIEGO HEALTHCARE SYSTEM
Practice Address - Street 2:3340 LA JOLLA VILLAGE DR.
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:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93444282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access