| NPI | 1073151700 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CHRISTOPHER AYODELE OTIKO Owner 818-836-2475  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208D00000X General Practice | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies | 
| Enumeration Date | 2019-12-12 | 
| Last Update Date | 2023-01-20 |