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Organization

UNKNVETERANS ADMINISTRATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL BURTON MSW (DIRECTOR, COMMUNITY CARE)
(818) 895-9596
Entity
Organization

Contact information

Practice address
21051 LASSEN ST, APARTMENT 78, CHATSWORTH, CA 91311-4273
(319) 490-9556
Mailing address
16111 PLUMMER ST, SEPULVEDA, CA 91343-2036
(818) 895-9596

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
261Q00000X-CLINIC/CE
CA
261QF0400X
Federally Qualified Health Center (FQHC)
261QF0400X-CLINIC/CE
CA
2865X1600X
Operational (Transportable) Military General Acute Care Hospital
Primary
2865X1600X-MILITARY
CA

Other

Enumeration date
11/01/2007
Last updated
11/01/2007
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