MEDICARE: VIKTORIA DRUZ MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	26972	CA
2	2251P0200X	Pediatric Physical Therapist	26972	CA

General Provider Information

NPI Number	:	1720316946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIKTORIA DRUZ MPT

Provider Business Mailing Address
First Line	:	22724 GAULT ST
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2306
Country	:	US
Telephone Number	:	818-522-3220
Fax Number	:

Provider Business Practice Location Address
First Line	:	22724 GAULT ST
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2306
Country	:	US
Telephone Number	:	818-522-3220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2009
Last Update Date	:	11/29/2009

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Directions to “ VIKTORIA DRUZ MPT” Practice Location

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