NPIMap

Organization Active NPI

San Diego Vamc

  • VA Clinic/Center
  • San Diego, CA
National Provider Identifier
1073196754
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
SAN DIEGO VAMC
Practice address
10455 Sorrento Valley Rd Ste 210
San Diego, CA 92121-1622
Phone
(702) 341-3020
Fax
(702) 341-3503
NPI assigned
Apr 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erin Denise Potter
Title
Npi Team Lead
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

10455 Sorrento Valley Rd Ste 210
San Diego, CA 92121-1622

Mailing address

PO Box 94416
Cleveland, OH 44101-4416
Phone (702) 341-3020

Other names 1

  • SAN DIEGO 1 VA CLINIC Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2081448VA San Diego HCS - Sorrento Valley Clinic Annex10455 Sorrento Valley Road, San Diego, CA 92121AccreditationMay 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
San Diego Vamc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10455 Sorrento Valley Rd
Ste 210
San Diego, CA 92121
Phone (858) 552-7475

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1073196754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94416",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014416",
            "telephone_number": "702-341-3020",
            "fax_number": "702-341-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10455 SORRENTO VALLEY RD STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211622",
            "telephone_number": "702-341-3020",
            "fax_number": "702-341-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM LEAD",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN DIEGO 1 VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.