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General NPI Number Information
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NPI Number | 1417603028
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Entity Type | Individual
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Provider Name | VICTORIA DJABOURIAN
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Gender | Female
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 153 E ROWLAND ST
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City | COVINA
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State | CA
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Zip | 91723-3049
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Country | US
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Telephone | 626-343-9261
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Fax |
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Provider Business Mailing Address
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Address Line | 153 E ROWLAND ST
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City | COVINA
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State | CA
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Zip | 91723-3049
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Country | US
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Telephone | 626-858-9460
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Fax | 626-858-9767
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 224900000X
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Taxonomy Name | Mastectomy Fitter
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License Number | C36902
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 224L00000X
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Taxonomy Name | Pedorthist
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License Number | CPED4606
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License Number State | CA
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Taxonomy #6
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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 | CA
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Taxonomy #7
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State | CA
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