NPIMap

Individual provider Active NPI

Christopher Ayodele Otiko, DPM

  • Podiatrist
  • Reseda, CA
National Provider Identifier
1346223997
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4159 Issued in CA
Practice address
6650 Reseda Blvd
Suite 101a
Reseda, CA 91335-5340
Phone
(818) 708-7668
Fax
(310) 943-1457
NPI assigned
Nov 28, 2005
Last updated
Sep 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4159 CA Primary

Addresses

Primary practice location

6650 Reseda Blvd
Suite 101a
Reseda, CA 91335-5340

Mailing address

6650 Reseda Blvd
Suite 101a
Reseda, CA 91335-5340
Phone (818) 708-7668

Other identifiers 2

IdentifierTypeStateIssuer
000E41591MedicaidCA
E4159OtherCALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Group Inc. CurrentSince Jul 24, 2022 Accepting new patients
Inland Empire Foot Doctors, Inc Podiatrist PastSince Apr 1, 2005 Accepting new patients
Wound Pros Nevada PastSince Feb 25, 2020 Accepting new patients
Ohio Wound Care Specialists PastSince Apr 2, 2022 Accepting new patients
Wound Pros Texas PastSince Dec 20, 2019 Accepting new patients
Msji Home Inc Past Accepting new patients
Wound Pros Georgia PastSince Aug 3, 2020 Accepting new patients
WP Texas Medical Group PastSince Apr 2, 2022 Accepting new patients
Ohio Wound Care Physicians PastSince Apr 2, 2022 Accepting new patients
Wound Pros Tennessee PastSince Sep 1, 2020 Accepting new patients
Wound Pros Arizona PastSince Sep 1, 2020 Accepting new patients
Wound Pros Washington PastSince Sep 1, 2020 Accepting new patients
Wound Pros Louisiana PastSince Mar 1, 2022 Accepting new patients
Mohammed Ahmeduddin DPM Podiatrist Past Accepting new patients
Wound Pros Utah PastSince Sep 1, 2020 Accepting new patients
Spectrum Eyecare Optometry Inc PastSince Nov 4, 2006 Accepting new patients
Wound Pros Michigan PastSince Jun 8, 2020 Accepting new patients
Texas Wound Care Management PastSince May 1, 2022 Accepting new patients
Wound Pros Florida PastSince Dec 1, 2019 Accepting new patients
Wound Pros New York PastSince Dec 9, 2019 Accepting new patients

Locations

1655 N Mount Vernon Ave
Ste B1
San Bernardino, CA 92411
Phone (909) 586-6260

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1346223997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 RESEDA BLVD",
            "address_2": "SUITE 101A",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355340",
            "telephone_number": "818-708-7668",
            "fax_number": "310-943-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 RESEDA BLVD",
            "address_2": "SUITE 101A",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355340",
            "telephone_number": "818-708-7668",
            "fax_number": "310-943-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIKO",
        "first_name": "CHRISTOPHER",
        "middle_name": "AYODELE",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E41591",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "E4159",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.