Organization
WP SUPPLY WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER OTIKO DPM (PRESIDENT)
(818) 836-2475
Entity
Organization
Contact information
Practice address
6180 N HOLLYWOOD BLVD STE 102, LAS VEGAS, NV 89115-1104
(323) 419-4609
Mailing address
4640 ADMIRALTY WAY STE 500, MARINA DEL REY, CA 90292-6636
(323) 480-4075
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
Other
Enumeration date
06/25/2022
Last updated
06/25/2022
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