WP Supply West

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WP SUPPLY WEST

Practice address

6180 N Hollywood Blvd Ste 102
Las Vegas, NV 89115-1104

Phone

(323) 419-4609

NPI assigned

Jun 25, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Otiko, DPM

Title

President

Phone

(818) 836-2475

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656115200000",
    "number": "1649902099",
    "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": "323-480-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6180 N HOLLYWOOD BLVD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891151104",
            "telephone_number": "323-419-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WP SUPPLY WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-25",
        "last_updated": "2022-06-25",
        "certification_date": "2022-06-25",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-836-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.