King Otha, is a
Community Health Worker based in Los Angeles, California. King Otha is licensed to practice in * (Not Available) (license number ) and his current practice location is
1774 Zonal Ave Bldg C, Los Angeles, California. He can be reached at his office (for appointments etc.) via phone at
(310) 221-6336.
NPI number for King Otha is 1508499062 and his current mailing address is 1774 Zonal Ave Bldg C, Los Angeles, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508499062.
Healthcare Provider's Profile
| Full Name | King Otha |
|---|
| Gender | Male |
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| Speciality | Community Health Worker |
|---|
| Location | 1774 Zonal Ave Bldg C, Los Angeles, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1508499062
- Provider Enumeration Date: 02/12/2020
- Last Update Date: 10/09/2023
Medical Identifiers
Medical identifiers for King Otha such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508499062 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 91961 (California) | Secondary |
| 104100000X | Social Worker | ACSW91961 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. King Otha is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
King Otha,
1774 Zonal Ave Bldg C,
Los Angeles, CA 90033-1064
Ph: (310) 221-6336 | King Otha,
1774 Zonal Ave Bldg C,
Los Angeles, CA 90033-1064
Ph: (310) 221-6336 |
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