Organization Active NPI

Burbank Foot Doctors

  • Podiatrist
  • Burbank, CA
National Provider Identifier
1063490035
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E41591 Issued in CA
Legal business name
BURBANK FOOT DOCTORS
Practice address
3906 W Burbank Blvd
Burbank, CA 91505-2117
Phone
(818) 238-9892
Fax
(818) 238-9893
NPI assigned
Jan 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christopher Ayudele Otiko, DPM
Title
DPM Owner
Phone
(818) 238-9892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E41591 CA Primary

Addresses

Primary practice location

3906 W Burbank Blvd
Burbank, CA 91505-2117

Mailing address

3906 W Burbank Blvd
Burbank, CA 91505-2117
Phone (818) 238-9892

Other identifiers 1

IdentifierTypeStateIssuer
5292240001OtherDMERC

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063490035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 W BURBANK BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052117",
            "telephone_number": "818-238-9892",
            "fax_number": "818-238-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 W BURBANK BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052117",
            "telephone_number": "818-238-9892",
            "fax_number": "818-238-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURBANK FOOT DOCTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "AYUDELE",
        "authorized_official_title_or_position": "DPM OWNER",
        "authorized_official_telephone_number": "818-238-9892",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E41591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5292240001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.