Organization
DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA
Active
Other names
CDVA Veterans Home of California West Los Angeles
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY NOMURA PHARM D (PHARMACY MANAGER)
(424) 832-8314
Entity
Organization
Contact information
Practice address
11500 NIMITZ AVE STE D301, LOS ANGELES, CA 90049-3566
(424) 832-8520
(424) 832-8315
Mailing address
11500 NIMITZ AVE, SUITE D301, LOS ANGELES, CA 90049-3566
(424) 832-8520
(424) 832-8315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHE50771
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133426
PK
—
Enumeration date
01/20/2012
Last updated
04/20/2017
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