Cynthia Kodama, Inc - Medicare Primary Care in Santa Monica, CA

Cynthia Kodama, Inc is a medicare enrolled primary clinic (Clinic/center) in Santa Monica, California. The current practice location for Cynthia Kodama, Inc is 2104 Wilshire Blvd, Santa Monica, California. For appointments, you can reach them via phone at (310) 882-8258. The mailing address for Cynthia Kodama, Inc is 1363 Pebble Hurst St, Monterey Park, California and phone number is (323) 791-9867.

Cynthia Kodama, Inc is licensed to practice in California (license number 20A10411). The clinic also participates in the medicare program and its NPI number is 1003231101. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (310) 882-8258.

Contact Information

Cynthia Kodama, Inc
2104 Wilshire Blvd
Santa Monica
CA 90403-5704
(310) 882-8258
Not Available

Primary Care Clinic Profile

Full NameCynthia Kodama, Inc
SpecialityClinic/Center
Location2104 Wilshire Blvd, Santa Monica, California
Authorized Official Name and PositionCynthia Kodama (OWNER)
Authorized Official Contact3237919867
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Cynthia Kodama, Inc
1363 Pebble Hurst St
Monterey Park
CA 91754-4422

Ph: (323) 791-9867
Cynthia Kodama, Inc
2104 Wilshire Blvd
Santa Monica
CA 90403-5704

Ph: (310) 882-8258

NPI Details:

NPI Number1003231101
Provider Enumeration Date02/26/2014
Last Update Date03/14/2014

Medicare PECOS Information:

Medicare PECOS PAC ID0547492118
Medicare Enrollment IDO20140414000655

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Medical Identifiers

Medical identifiers for Cynthia Kodama, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003231101NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center 20A10411 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Cynthia Kodama, Inc acts as a billing entity for following providers:
Provider NameCynthia Kodama
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1013166503
PECOS PAC ID: 4981741238
Enrollment ID: I20091022000566

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