Bodon, Lisa Monique

Bodon, Lisa Monique is an individual health care provider with primary practice located at 555 E Tachevah Dr Suite 2W #201, Palm Springs CA 92262-5750. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Bodon, Lisa Monique can be contacted via phone (760) 323-9309.

Contact Information

Primary practice address
555 E Tachevah Dr Suite 2W #201 Palm Springs CA 92262-5750
Phone: (760) 323-9309
Fax: (760) 610-8995
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X A97869 California

Profile Details

NPI number 1063619013
LBN Legal business name Bodon, Lisa Monique
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2007
Last updated Nov 20th, 2012 - about 12 years 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1063619013 NPPES
California MEDICAID 00A978690
California MEDICAID GR0042690
California Other ZZZ50078Y

Popular Providers