# WOUND PROS NEVADA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053959791
- **Authorized official:** DR. CHRISTOPHER AYODELE OTIKO DPM (PRESIDENT)
- **Authorized official phone:** (818) 836-2475

## Contact information

- **Practice address:** 1700 E DESERT INN RD STE 103, LAS VEGAS, NV 89169-3206
- **Practice address phone:** (888) 880-3451
- **Mailing address:** 4640 ADMIRALTY WAY STE 500, MARINA DEL REY, CA 90292-6636
- **Mailing address phone:** (888) 880-3451
- **Mailing address fax:** (323) 433-9177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 12/12/2019
- **Last updated:** 05/23/2022