Organization
BIOGENX MEDICAL
Active
Other names
Coast to Coast Medical, Biogenx Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER A OTIKO DPM (MANAGER)
(818) 836-2475
Entity
Organization
Contact information
Practice address
620 S GLENDORA AVE STE B, GLENDORA, CA 91740-6815
(818) 836-2475
(310) 943-1475
Mailing address
620 S GLENDORA AVE STE B, GLENDORA, CA 91740-6815
(818) 836-2475
(310) 943-1475
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
G77666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G77666
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
10/02/2017
Last updated
03/02/2018
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