Cynthia Chizuko Kodama, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

20A10411 Issued in CA

Practice address

1499 Huntington Dr Ste 418
South Pasadena, CA 91030-5459

Phone

(626) 460-8398

NPI assigned

Sep 9, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cindi Kodama Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cynthia Kodama, Inc

  • Clinic/Center
  • Santa Monica, CA
  • NPI 1003231101
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1013166503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 PEBBLE HURST ST",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544422",
            "telephone_number": "323-791-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 HUNTINGTON DR STE 418",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910305459",
            "telephone_number": "626-460-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODAMA",
        "first_name": "CYNTHIA",
        "middle_name": "CHIZUKO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A10411",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "20A10411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "B4719516",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDI",
            "last_name": "KODAMA",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dolly Bahl Kim, MD MBA
• So Hyeoung Kim
• Lianna Kirakosyan
• Braley Brooke Klatt
• Dawn Knight
• Kaitlyn Mieko Kodama
• Bonjun Koo
• Timothy Kook, DDS
• Sarah Kovatch, MA
• John Krabbe

• Neuromusculoskeletal Medicine & OMM Physician in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Neuromusculoskeletal Medicine & OMM Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.