DR. CYNTHIA CHIZUKO KODAMA (NPI# 1013166503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013166503 |
| Entity Type | Individual |
| Full Name | DR. CYNTHIA CHIZUKO KODAMA |
| Other Name | CINDI KODAMA |
| Credential | D.O. |
| Practice Address |
1416 El Centro St 300 South Pasadena CA 91030-3202 |
| Mailing Address |
1363 Pebble Hurst St Monterey Park CA 91754-4422 |
| Practice Telephone | 3237919867 |
| Mailing Telephone | 3237919867 |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2015-09-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204D00000X | Neuromusculoskeletal Medicine & OMM | 20A10411 | CA | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 20A10411 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRIVER'S LICENSE | B4719516 | 01 |
| Street Address |
1416 EL CENTRO ST 300 |
| City | SOUTH PASADENA |
| State | CA |
| Zip Code | 91030-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444674 | Heather Marie Delman | Marriage & Family Therapist | 1425 Oneonta Knoll, So Pasadena, CA 91030 | 2020-10-09 |
| 1568986883 | Richard Gonzalez | Behavior Technician | 625 S Fair Oaks Ave #300, South Pasadena, CA 91030 | 2017-07-28 |
| 1366991150 | Nereida Acosta | Behavioral Analyst | 625 S Fair Oaks Ave, Suite 200, South Pasadena, CA 91030 | 2016-09-22 |
| 1043618192 | Clelia Alonzo | Specialist | 1317 Huntington Dr., Cos Services Building, South Pasadena, CA 91030 | 2014-12-05 |
| 1740687359 | Francisco Acosta | Behavioral Analyst | 625 S Fair Oaks Ave, Suite 300, South Pasadena, CA 91030 | 2014-11-25 |
| 1700289030 | James Y. Law | Pharmacist | 1678 Camino Lindo, S. Pasadena, CA 91030 | 2014-10-01 |
| 1760893994 | Joanna Ku | Rehabilitation Practitioner | 1855 Hill Drive, South Pasadena, CA 91030 | 2014-05-09 |
| 1336568294 | Sarah Sicher | Psychiatry & Neurology | 729 Mission St Ste 300, South Pasadena, CA 91030 | 2014-04-08 |
| 1265799530 | Xiaodong Li | Pathology | 314 Monterey Rd Unit 14, South Pasadena, CA 91030 | 2012-04-11 |
| 1831477124 | South Pasadena General Dentistry Inc | Dentist | 1506 Huntington Drive, South Pasadena, CA 91030 | 2011-08-03 |
| Find all providers in zip 91030 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
| 1780080028 | Maria Planthara Chatham | General Practice | 7400 Sun Island Dr S Apt 501, South Pasadena, FL 33707-4419 | 2014-11-14 |
| 1548566813 | Alaina Nicole Fields | General Practice | 1244 Huntington Dr, South Pasadena, CA 91030-4544 | 2011-02-04 |
| 1639261704 | Eugh Shibasaki Jr. | General Practice | 1420 Fair Oaks Ave, South Pasadena, CA 91030 | 2006-09-28 |
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| 1255939674 | Kiira Health Practice Ca PC | General Practice | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 |
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| 1598362709 | Afua Takyi | General Practice | 1555 River Park Dr Ste 211, Sacramento, CA 95815-4604 | 2020-10-01 |
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH PASADENA |
| Zip Code | 91030 |
Please comment or provide details below to improve the information on DR. CYNTHIA CHIZUKO KODAMA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.