Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE MADAMBA (FNP-BC)
(310) 500-0430
Entity
Organization
Contact information
Practice address
5939 CEDROS AVE APT A, VAN NUYS, CA 91411-3104
(310) 500-0430
Mailing address
5939 CEDROS AVE APT A, VAN NUYS, CA 91411-3104
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
95004376
CA
Other
Enumeration date
08/21/2016
Last updated
08/21/2016
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