Provider Demographics
NPI:1730330572
Name:GODES, JOHN SHERWIN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SHERWIN
Last Name:GODES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 N ROCKHURST DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-6051
Mailing Address - Country:US
Mailing Address - Phone:714-538-2003
Mailing Address - Fax:
Practice Address - Street 1:978 N ROCKHURST DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-6051
Practice Address - Country:US
Practice Address - Phone:714-538-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC27822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine