# DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CDVA Veterans Home of California West Los Angeles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912278003
- **Authorized official:** STANLEY NOMURA PHARM D (PHARMACY MANAGER)
- **Authorized official phone:** (424) 832-8314

## Contact information

- **Practice address:** 11500 NIMITZ AVE STE D301, LOS ANGELES, CA 90049-3566
- **Practice address phone:** (424) 832-8520
- **Practice address fax:** (424) 832-8315
- **Mailing address:** 11500 NIMITZ AVE, SUITE D301, LOS ANGELES, CA 90049-3566
- **Mailing address phone:** (424) 832-8520
- **Mailing address fax:** (424) 832-8315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHE50771 | CA | Yes |

## Other

- **Enumeration date:** 01/20/2012
- **Last updated:** 04/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2133426 | PK | — |