MEDICARE: DR. VICTORIA NAIMAN DDS

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	122300000X	Dentist	64843	CA

General Provider Information

NPI Number	:	1811365042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA NAIMAN DDS

Provider Business Mailing Address
First Line	:	10856 MORRISON ST APT 4
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-4666
Country	:	US
Telephone Number	:	323-719-6417
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 N LARCHMONT BLVD STE 1010
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-6410
Country	:	US
Telephone Number	:	323-682-0674
Fax Number	:

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

Provider Enumeration Date	:	09/03/2015
Last Update Date	:	01/14/2020

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