The Diabetic Shoe Corp

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

E4159 Issued in CA

Legal business name

THE DIABETIC SHOE CORP

Practice address

10639 Burbank Blvd
N Hollywood, CA 91601-2512

Phone

(866) 712-7463

Fax

(818) 508-1819

NPI assigned

Dec 16, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Christopher A Otiko, DPM

Title

Ceo

Phone

(818) 766-6776

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

The Diabetic Shoe Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Diabetic Shoe Corporation

  • Durable Medical Equipment & Medical Supplies
  • Huntington Park, CA
  • NPI 1518907492
  NPD tax ID

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700862281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10639 BURBANK BLVD",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012512",
            "telephone_number": "866-712-7463",
            "fax_number": "818-508-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10639 BURBANK BLVD",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012512",
            "telephone_number": "866-712-7463",
            "fax_number": "818-508-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DIABETIC SHOE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-766-6776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "E4159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4875930001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nicholas Theodore Tepelidis, DPM
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• Truecare Medical Clinic Inc
• Tsilya Bass MD Inc.
• Twin Hearts Care Home
• United Surgery Center LLC

• Durable Medical Equipment & Medical Supplies in N Hollywood, CA
• Providers in N Hollywood, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• 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.