Provider Demographics
NPI:1164797684
Name:GODOY, LUIS ARMANDO (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ARMANDO
Last Name:GODOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2335 STOCKTON BLVD.
Mailing Address - Street 2:NAOB SUITE 6120
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-734-3861
Mailing Address - Fax:916-734-3066
Practice Address - Street 1:2335 STOCKTON BLVD.
Practice Address - Street 2:NAOB SUITE 6120
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2200
Practice Address - Country:US
Practice Address - Phone:916-734-3861
Practice Address - Fax:916-734-3006
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA140225208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery