Advanced Wound Care Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ADVANCED WOUND CARE GROUP

Practice address

301 N Prairie Ave Ste 202
Inglewood, CA 90301-4509

Phone

(323) 480-4075

NPI assigned

Apr 25, 2022

Last updated

May 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Ayodele Otiko, MD

Title

President

Phone

(818) 836-2475

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1104560119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY STE 500",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926636",
            "telephone_number": "818-836-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PRAIRIE AVE STE 202",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014509",
            "telephone_number": "323-480-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WOUND CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "AYODELE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-836-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.