Individual provider Active NPI

Jeffrey T. Godun, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1386755106
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 26285 Issued in CA
Practice address
12409 Rancho Bernardo Rd
San Diego, CA 92128-2143
Phone
(858) 485-8220
Fax
(858) 485-8222
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 26285 CA Primary

Addresses

Primary practice location

12409 Rancho Bernardo Rd
San Diego, CA 92128-2143

Mailing address

11349 Avenida de Los Lobos
Apt E
San Diego, CA 92127-5892
Phone (858) 485-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061101000541 CA Practitioner - Chiropractic 0143227272 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 26285CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California University of Health Sciences Chiropractor CurrentSince May 25, 2022 Accepting new patients
Dr. Laura T. Sowers-Mokuahi DC, LLC Chiropractor PastSince May 13, 2014 Accepting new patients

Locations

14642 Newport Ave
Ste 330
Tustin, CA 92780
Phone (562) 943-7125

16200 Amber Valley Dr
Whittier, CA 90604
Phone (562) 943-7125

Interoperability endpoints

  • Direct secure messaging: jeffrey.godun.1@29676.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386755106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11349 AVENIDA DE LOS LOBOS",
            "address_2": "APT E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275892",
            "telephone_number": "858-485-8220",
            "fax_number": "858-485-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282143",
            "telephone_number": "858-485-8220",
            "fax_number": "858-485-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODUN",
        "first_name": "JEFFREY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 26285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.