Provider Demographics
NPI:1972789188
Name:IGNATIUS P. GODOY, M.D., INC.
Entity type:Organization
Organization Name:IGNATIUS P. GODOY, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MISS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:562-634-0449
Mailing Address - Street 1:16660 PARAMOUNT BLVD
Mailing Address - Street 2:STE. 206
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5433
Mailing Address - Country:US
Mailing Address - Phone:424-242-1464
Mailing Address - Fax:562-634-6075
Practice Address - Street 1:16660 PARAMOUNT BLVD
Practice Address - Street 2:STE. 206
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5433
Practice Address - Country:US
Practice Address - Phone:562-634-0449
Practice Address - Fax:562-634-6075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA048799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0075070OtherMEDI-CAL