VA Greater Los Angeles Medical Center

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

1031 Issued in CA

Legal business name

VA GREATER LOS ANGELES MEDICAL CENTER

Practice address

11301 Wilshire Blvd
Los Angeles, CA 90073

Phone

(310) 478-3711

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Wallace Eisner, RKT

Title

Kinesiotherapist

Phone

(310) 478-3711

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952496572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12122 EXCELSIOR DRIVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90650",
            "telephone_number": "562-863-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90073",
            "telephone_number": "310-478-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA GREATER LOS ANGELES MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EISNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "KINESIOTHERAPIST",
        "authorized_official_telephone_number": "310-478-3711",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RKT"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "CA",
            "license": "1031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VA Greater la Healthcare System
• VA Greater Los Angeles Healthcare
• VA Greater Los Angeles Healthcare System
• VA Greater Los Angeles Healthcare System
• VA Greater Los Angeles Healthcare System, West Los Angeles126
• VA Greater Los Angeles Nuclear Medicine Department
• VA Hospital
• VA Medical Center
• VA Medical Center of West la
• VA Wla Healthcare Center

• Rehabilitation Hospital in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Rehabilitation Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.