Organization
VITOS PEDORTHIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK DJABOURIAN (OWNER)
(626) 858-9460
Entity
Organization
Contact information
Practice address
153 E ROWLAND ST, COVINA, CA 91723-3049
(626) 858-9460
Mailing address
153 E ROWLAND ST, COVINA, CA 91723-3049
(626) 858-9460
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224900000X
Mastectomy Fitter
—
—
224L00000X
Pedorthist
—
—
224P00000X
Prosthetist
—
—
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/04/2022
Last updated
11/14/2025
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