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General NPI Number Information
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NPI Number | 1083855647
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Entity Type | Individual
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Provider Name | VICTORIA MELNIKOVA O.T
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Gender | Female
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 505 SHATTO PL STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90020-1777
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Country | US
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Telephone | 213-736-0450
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Fax |
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Provider Business Mailing Address
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Address Line | 5334 LINDLEY AVE UNIT 109
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City | ENCINO
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State | CA
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Zip | 91316-2907
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Country | US
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Telephone | 323-449-5577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2692
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License Number State | CA
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