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General NPI Number Information
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NPI Number | 1275885824
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Entity Type | Organization
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Legal Business Name | VITALIS ORTHOPEDICS
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Dates
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Enumeration Date | 10/06/2012
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Last Update Date | 10/06/2012
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Provider Practice Location Address
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Address Line | 7618 WOODMAN AVE SUITE 11
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City | PANORAMA CITY
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State | CA
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Zip | 91402-6534
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Country | US
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Telephone | 818-530-3161
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Fax | 818-373-0030
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Provider Business Mailing Address
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Address Line | 7618 WOODMAN AVE SUITE 11
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City | PANORAMA CITY
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State | CA
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Zip | 91402-6534
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Country | US
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Telephone | 818-530-3161
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Fax | 818-373-0030
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Authorized Official
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Title or Position | CEO
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Name | ROBERT AVRAMIAN
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Credential | C.PED
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Telephone | 818-530-3161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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