=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548176340
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT GODINA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2026
-----------------------------------------------------
Last Update Date | 08/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 47915 OASIS ST STE B
-----------------------------------------------------
City | INDIO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92201-6950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-239-9187
-----------------------------------------------------
Fax | 760-600-5037
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25141 SILENT CREEK RD
-----------------------------------------------------
City | MORENO VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92553-4337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225400000X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------