Individual provider Active NPI

Nikolas Christopher Victoria, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1790536621
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16449 Issued in CA
Practice address
2020 Zonal Ave RM 115
Los Angeles, CA 90089-0121
Phone
(323) 409-5610
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16449 CA Primary

Addresses

Primary practice location

2020 Zonal Ave RM 115
Los Angeles, CA 90089-0121

Mailing address

2020 Zonal Ave RM 115
Los Angeles, CA 90089-0121
Phone (323) 409-5610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007000173 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8820595077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1790536621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 ZONAL AVE RM 115",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890121",
            "telephone_number": "323-409-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 ZONAL AVE RM 115",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890121",
            "telephone_number": "323-409-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "NIKOLAS",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "16449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.