Provider Demographics
NPI:1780865279
Name:CAI, VICTORIA
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:
Last Name:CAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19634 VENTURA BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2967
Mailing Address - Country:US
Mailing Address - Phone:818-705-5415
Mailing Address - Fax:818-705-5783
Practice Address - Street 1:19634 VENTURA BLVD STE 111
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2967
Practice Address - Country:US
Practice Address - Phone:818-705-5415
Practice Address - Fax:818-705-5783
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12153171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist