OrganizationActive
Advanced Wound Care Group
NPI 1104560119 · General Practice Physician · Inglewood, CA
Provider details
- NPI number
- 1104560119
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Christopher Otiko, President(818) 836-2475
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
Practice location
301 N Prairie Ave Ste 202
Inglewood, CA 90301-4509
Phone: (323) 480-4075
Approximate (ZIP-level) locationGet directions
Mailing address
4640 Admiralty Way Ste 500
Marina Del Rey, CA 90292-6636
Registry dates
- Enumerated
- 2022-04-25
- Last updated
- 2022-05-23
- Certified
- 2022-05-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.