# THE DIABETIC SHOE CORP

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

## Provider details

- **NPI number:** 1700862281
- **Authorized official:** DR. CHRISTOPHER A OTIKO DPM (CEO)
- **Authorized official phone:** (818) 766-6776

## Contact information

- **Practice address:** 10639 BURBANK BLVD, N HOLLYWOOD, CA 91601-2512
- **Practice address phone:** (866) 712-7463
- **Practice address fax:** (818) 508-1819
- **Mailing address:** 10639 BURBANK BLVD, N HOLLYWOOD, CA 91601-2512
- **Mailing address phone:** (866) 712-7463
- **Mailing address fax:** (818) 508-1819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | E4159 | CA | Yes |

## Other

- **Enumeration date:** 12/16/2005
- **Last updated:** 08/22/2020