Organization
WOUND PROS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER AYODELE OTIKO DPM (PRESIDENT)
(818) 836-2475
Entity
Organization
Contact information
Practice address
100 S JUNIPER ST FL 3, PHILADELPHIA, PA 19107-1316
(888) 880-3451
Mailing address
4640 ADMIRALTY WAY STE 500, MARINA DEL REY, CA 90292-6636
(818) 836-2475
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
06/08/2020
Last updated
07/01/2022
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