Provider Demographics
NPI:1952335127
Name:VETERAN'S AFFAIRS MEDICAL CENTER
Entity Type:Organization
Organization Name:VETERAN'S AFFAIRS MEDICAL CENTER
Other - Org Name:UNIVERSITY OF CALIFORNIA SAN DIEGO MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CADENHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-552-8585
Mailing Address - Street 1:2424 CARMEL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3350 VIA LA JOLLA
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:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44519282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital