| NPI | 1942824719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER AYODELE OTIKO President 818-836-2475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2022-05-23 |