Jun Goeku, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14735 Issued in CA

Practice address

12012 S Wilmington Avenue
Los Angeles, CA 90059

Phone

(310) 668-4515

Fax

(310) 763-8909

NPI assigned

Feb 13, 2007

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992847867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 LOOMIS STREET",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "90712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12012 S WILMINGTON AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90059",
            "telephone_number": "310-668-4515",
            "fax_number": "310-763-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEKU",
        "first_name": "JUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel C Godwin, NP
• Cathleen Ann Godzik, MEDICAL DOCTOR
• Madison Therese Goe, PA-C
• Nancy Louise Goebel, D.D.S.
• Evelia A Goebelsmann, NP
• Gati Ajani Goel, M.D.
• Keshav Prateek Goel, MD
• Khushboo Goel, MD
• Elizabeth Mary Goetchius, MSW, LCSW
• Matthew Bidwell Goetz, MD

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.