Gary Godorov, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A78224 Issued in CA

Practice address

1001 N Tustin Ave
Western Medical Center - Emergency Dept - Dr. Godorov
Santa Ana, CA 92705-3502

Phone

(310) 463-7387

NPI assigned

Jun 4, 2006

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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 Medicine

State licenses

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Bellflower, CA
  • NPI 1043242555
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Centinela Freeman Emergency Medical Associates

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1962539684
  NPD (past)
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD (past)
• Grapevine Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1982907770
  NPD (past)
• Max Franklin Lebow, a Medical Corporation

  dba Emergency Physician Services Medical Assoicates

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1043255813
  NPD (past)
• Reliant Immediate Care Medical Group, Inc.

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1316635097
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1437197068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 MAIN ST",
            "address_2": "# 401",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453006",
            "telephone_number": "310-463-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N TUSTIN AVE",
            "address_2": "WESTERN MEDICAL CENTER - EMERGENCY DEPT - DR. GODOROV",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053502",
            "telephone_number": "310-463-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODOROV",
        "first_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A78224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nadim Nader Gobran
• Corie Gochicoa, ACSW
• Alyssa Godina
• Elvia Godinez Gomez
• Yesenia Ruby Godinez, B.A.
• Andrea Isabel Godoy-Orantes
• Catherine Goerndt
• Hyun Jin Goetz
• Harinder S. Gogia, M.D.
• Sherin Gogia

• Emergency Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.