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General NPI Number Information
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NPI Number | 1922747930
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Entity Type | Individual
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Provider Name | PETER JOSEPH GODOY III DPM
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Gender | Male
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 5565 GROSSMONT CENTER DR STE 3 SUITE 510
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City | LA MESA
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State | CA
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Zip | 91942-3007
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Country | US
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Telephone | 619-303-7130
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Fax |
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Provider Business Mailing Address
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Address Line | 5565 GROSSMONT CENTER DR STE 3 SUITE 510
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City | LA MESA
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State | CA
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Zip | 91942-3007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5951001465
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 5951001465
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E6178
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License Number State | CA
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