Boddy, Mark Gordon

Boddy, Mark Gordon is an individual health care provider with primary practice located at 725 Welch Rd , Palo Alto CA 94304-1601. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine. Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine is his primary health care specialty. Boddy, Mark Gordon can be contacted via phone (650) 497-8000.

Contact Information

Primary practice address
725 Welch Rd Palo Alto CA 94304-1601
Phone: (650) 497-8000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G89220 California
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 032519 Georgia
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X G89220 California

Profile Details

NPI number 1518059880
LBN Legal business name Boddy, Mark Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Apr 19th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518059880 NPPES
Georgia MEDICAID 00609221C

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