Biogenx Medical

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

G77666 Issued in CA

Legal business name

BIOGENX MEDICAL

Doing business as

Biogenx Medical
Coast to Coast Medical

Practice address

620 S Glendora Ave Ste B
Glendora, CA 91740-6815

Phone

(818) 836-2475

Fax

(310) 943-1475

NPI assigned

Oct 2, 2017

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

Manager

Phone

(818) 836-2475

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Biogenx Medical Doing business as
• Coast to Coast Medical Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Mankin Anderson, AUD

  • Audiologist
  • Bend, OR
  • NPI 1083234710
  NPD (past)

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1962912246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S GLENDORA AVE STE B",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406815",
            "telephone_number": "818-836-2475",
            "fax_number": "310-943-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S GLENDORA AVE STE B",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406815",
            "telephone_number": "818-836-2475",
            "fax_number": "310-943-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOGENX MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-836-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "G77666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL  LICENSE",
            "identifier": "G77666",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Biogenx Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coast to Coast Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bharathi S Vayuvegula MD PHD Inc
• Nutan Bhaskar, MD
• Sasinee Jade Bhosai, NP
• Richard Mark Biebuyck, M.D.
• Billy P. Leon M.D. Inc.
• Josue Blanco
• Jaclyn Anne Blanset
• Bliss Health Care Inc.
• Body 101
• Michael Bogey, M.D.

• Preventive Medicine/Occupational Environmental Medicine Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; 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.