Provider Demographics
NPI:1326127580
Name:GODOY, IGNATIUS P (MD)
Entity Type:Individual
Prefix:MR
First Name:IGNATIUS
Middle Name:P
Last Name:GODOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16660 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5458
Mailing Address - Country:US
Mailing Address - Phone:562-634-9433
Mailing Address - Fax:562-634-6075
Practice Address - Street 1:16660 PARAMOUNT BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5458
Practice Address - Country:US
Practice Address - Phone:562-634-9433
Practice Address - Fax:562-634-6075
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA048799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0075070OtherMEDICAL