| NPI | 1104571389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER AYODELE OTIKO President 818-708-7668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2023-01-20 |