VETERANS HOME OF CALIFORNIA - WEST LOS ANGELES
NPI 1821316076
Skilled Nursing Facility in Los Angeles, CA

Active since May 12, 2010CLIA 05D2012666 · Waiver
11500 NIMITZ AVE, LOS ANGELES, CA 90049(818) 742-1752(818) 742-1758 Get Directions Write a Review

NPPES record last updated: May 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2020, Apr 29, 2019, Jul 13, 2016 (3 updates tracked since 2016).

About Veterans Home Of California - West Los Angeles NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VETERANS HOME OF CALIFORNIA - WEST LOS ANGELES (NPI 1821316076) is a healthcare organization registered as a skilled nursing facility in Los Angeles, California and active in the NPI registry since May 2010. The organization holds a CLIA Waiver certificate valid through April 9, 2028 and lists Ani Khachatoorian, Finance Manager, as its authorized official.

NPPES Registry Identity

NPI1821316076
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameDEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA
Location Address11500 NIMITZ AVELos Angeles, CA 90049-3566
Mailing AddressPo Box 942895Sacramento, CA 94295-0001 · (916) 657-9349 · Fax (916) 653-1795
Fax(818) 742-1758
Organization SubpartNo
Authorized OfficialAni KhachatoorianFinance Manager · (424) 832-8551
Enumeration DateMay 12, 2010
Last NPPES UpdateMay 15, 20203 updates tracked since enumeration
NPPES CertifiedMay 15, 2020
NPI 1821316076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 550002051
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Also ListedAssisted Living FacilityTaxonomy 310400000X · License 197607966 (CA)
11500 NIMITZ AVE, Los Angeles, CA 90049

Other Names 1

Doing Business AsVeterans Home Of California - West Los Angeles

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2012666

Veterans Home Of California-Glavc · Los Angeles, CA
Active · expires Apr 9, 2028
CLIA Number05D2012666
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 10, 2026
Certificate Expiration DateApril 9, 2028
Laboratory DirectorPaul De Jesus Fortaleza
Laboratory Phone(424) 832-8238
Laboratory LocationVeterans Home Of California-Glavc11500 Nimitz Ave, Los Angeles, CA 90049
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Social Worker (Clinical)
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Dietitian, Registered
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Psychiatry & Neurology (Geriatric Psychiatry)
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Pharmacist (Pharmacotherapy)
11500 NIMITZ AVE, ATTN: PHARMACY
LOS ANGELES, CA 90049
Surgery
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Occupational Therapist (Physical Rehabilitation)
11500 NIMITZ AVE, REHAB 3 FLOOR
LOS ANGELES, CA 90049
Psychologist (Clinical)
11500 NIMITZ AVE
LOS ANGELES, CA 90049

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Department Of Veterans Affairs Of The State Of California's NPI number?

The NPI number for Department Of Veterans Affairs Of The State Of California is 1821316076. It was assigned to this organization in the NPPES registry on May 12, 2010. The provider is doing business as Veterans Home Of California - West Los Angeles.

Where is Department Of Veterans Affairs Of The State Of California located?

Department Of Veterans Affairs Of The State Of California is located at 11500 Nimitz Ave, Los Angeles, CA 90049. The listed phone number is (818) 742-1752.

What is Department Of Veterans Affairs Of The State Of California's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Department Of Veterans Affairs Of The State Of California hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2012666) is associated with this NPI, valid through April 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Department Of Veterans Affairs Of The State Of California was last updated on May 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.