Tina Godwin Wadiwala, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A11528 Issued in CA

Practice address

107 S Fair Oaks Ave Ste 313
Pasadena, CA 91105-2084

Phone

(626) 487-7766

NPI assigned

Dec 15, 2010

Last updated

May 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tina Godwin Professional 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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

• Pasadena Family Medicine Inc

  dba Huntington Family Medicine

  • General Practice Physician
  • Pasadena, CA
  • NPI 1033221627

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1215230164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S FAIR OAKS AVE STE 313",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052084",
            "telephone_number": "626-487-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S FAIR OAKS AVE STE 313",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052084",
            "telephone_number": "626-487-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Bellefontaine St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053132",
            "country_code": "US",
            "telephone_number": "626-792-1912",
            "fax_number": "626-792-1960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 E Spring Valley Pike",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454582653",
            "country_code": "US",
            "telephone_number": "937-436-3117",
            "fax_number": "937-436-0730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADIWALA",
        "first_name": "TINA",
        "middle_name": "GODWIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "GODWIN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Matthew Wada
• Takashi Michael Wada, MD
• Carley Ann Wade, OTR/L
• Levi Carl Wade
• Vanessa Mary Wade, LVN
• Corinne Rebecca Wadley
• Alexis Katherine Wadsworth
• Carolyn Joyce Wadsworth, NURSE PRACTITONER
• Linda Mans Wagener, PH.D.
• Christy Ann Wagner, LVN

• Family Medicine Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.