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Organization

VIVIANO CUSTOM SHOE COMPANY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH FRANK VIVIANO CERTIFIED PEDORTHIST (PRESIDENT)
(818) 292-8250
Entity
Organization

Contact information

Practice address
7801 CANOGA AVE STE 12, CANOGA PARK, CA 91304-5019
(818) 292-8250
(818) 292-8690
Mailing address
7801 CANOGA AVE STE 12, CANOGA PARK, CA 91304-5019
(818) 292-8250
(818) 292-8690

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
101-697629
CA
335E00000X
Prosthetic/Orthotic Supplier
101-697629
CA

Other

Enumeration date
04/16/2011
Last updated
09/19/2024
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