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: October 25, 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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Veterans Home Of California - West Los Angeles is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

21

Medicare enrollment records show 21 clinicians reassign Medicare billing to Veterans Home Of California - West Los Angeles, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

Internal Medicine4
Nurse Practitioner4
Registered Dietitian or Nutrition Professional4
Family Practice3
Clinical Psychologist2
General Practice1
Hospice/Palliative Care1
Podiatry1
1 other specialty1

Nearest to this location (20)

See all 21
Clinical Psychologist
NPI 1588975247
11500 NIMITZ AVE
Los Angeles, CA 90049
(424) 832-8200
✔ PECOS✔ Accepts MedicareSame address
General Practice
NPI 1508914573
11500 NIMITZ AVE
Los Angeles, CA 90049
(424) 832-8470
✔ PECOSSame address
Internal Medicine
NPI 1184070427
2070 CENTURY PARK E
Los Angeles, CA 90067
(424) 522-7100
✔ PECOS✔ Accepts Medicare3.0 mi
Nurse Practitioner
NPI 1699119636
10850 STEVER ST
Culver City, CA 90230
(310) 714-9821
✔ PECOS✔ Accepts Medicare5.9 mi
Family Practice
NPI 1336368190
6350 LAUREL CANYON BLVD STE 205
North Hollywood, CA 91606
(818) 325-2090
✔ PECOS✔ Accepts Medicare9.7 mi
Nurse Practitioner
NPI 1679233829
1050 ENGLISH OAKS DR
Arcadia, CA 91006
(626) 497-7397
✔ PECOS✔ Accepts Medicare24 mi
Podiatry
NPI 1841246253
3530 WEST POMONA BLVD
Pomona, CA 91769
(909) 595-1221
✔ PECOS✔ Accepts Medicare38 mi
Family Practice
NPI 1265481923
335 E AVENUE I URGENT CARE
Lancaster, CA 93535
(661) 471-4020
✔ PECOS✔ Accepts Medicare57 mi
Registered Dietitian or Nutrition Professional
NPI 1407687767
2811 W CESAR CHAVEZ BLVD
Fresno, CA 93706
(559) 493-4400
✔ Accepts Medicare199 mi
Registered Dietitian or Nutrition Professional
NPI 1790470623
2811 W CALIFORNIA AVE
Fresno, CA 93706
(559) 493-4400
✔ Accepts Medicare199 mi
Registered Dietitian or Nutrition Professional
NPI 1255857678
2811 W CALIFORNIA AVE
Fresno, CA 93706
(559) 493-4544
✔ Accepts Medicare199 mi
Internal Medicine
NPI 1588625826
2811 W CESAR CHAVEZ BLVD
Fresno, CA 93706
(559) 493-4433
✔ PECOS✔ Accepts Medicare202 mi
Internal Medicine
NPI 1609958594
4015 N FRESNO ST SUITE 108
Fresno, CA 93726
(559) 266-0759
✔ PECOS✔ Accepts Medicare203 mi
Internal Medicine
NPI 1255430286
5771 N FRESNO ST SUITE 109
Fresno, CA 93710
(559) 222-6500
✔ PECOS205 mi
Psychiatry
NPI 1619055118
1221 E SPRUCE AVE
Fresno, CA 93720
(559) 261-2799
✔ PECOS✔ Accepts Medicare205 mi
Nurse Practitioner
NPI 1669874046
7471 N FRESNO ST
Fresno, CA 93720
(559) 436-4500
✔ PECOS✔ Accepts Medicare206 mi
Hospice/Palliative Care
NPI 1649203522
3328 CHURN CREEK RD STE A
Redding, CA 96002
(530) 222-0895
✔ PECOS✔ Accepts Medicare497 mi
Nurse Practitioner
NPI 1518007137
2425 SONOMA ST
Redding, CA 96001
(530) 241-1144
✔ PECOS✔ Accepts Medicare499 mi
Family Practice
NPI 1164686127
1760 GOLD ST SUITE 600
Redding, CA 96001
(530) 247-8200
✔ PECOS✔ Accepts Medicare499 mi
Clinical Psychologist
NPI 1528036332
1302 OREGON ST
Redding, CA 96001
(530) 244-4436
✔ PECOS✔ Accepts Medicare499 mi
See all 21 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.

Is Department Of Veterans Affairs Of The State Of California enrolled in Medicare?

Yes. Department Of Veterans Affairs Of The State Of California is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Department Of Veterans Affairs Of The State Of California?

According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 9 Medicare specialties reassign their Medicare billing to Department Of Veterans Affairs Of The State Of California. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (4), Nurse Practitioner (4) and Registered Dietitian or Nutrition Professional (4). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.