Individual provider Active NPI

Valerie Ezinwa Otti, MD

  • Family Medicine Physician
  • Marina del Rey, CA
National Provider Identifier
1356043673
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A202157 Issued in CA
Practice address
4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424
Phone
(310) 827-3700
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A202157 CA Primary

Addresses

Primary practice location

4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-5200

Other practice location 1

1520 San Pablo St Ste 1300
Los Angeles, CA 90033-5312
Phone (323) 442-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208002086 CA Order and Referring Only - Family PracticePractitioner - Family Practice 6406299270

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1356043673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 100",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925424",
            "telephone_number": "310-827-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 San Pablo St Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335312",
            "country_code": "US",
            "telephone_number": "323-442-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTI",
        "first_name": "VALERIE",
        "middle_name": "EZINWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A202157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.