| NPI | 1063619013 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2007-07-02 |
| Last Updated | 2012-11-20 |
| Mailing Address | 555 E Tachevah Dr, Suite 2w #201 Palm Springs, CA 92262-5750 United States Phone: (760) 323-9309 | Fax: (760) 610-8995 📍 View Map |
| Primary Practice Address | 555 E Tachevah Dr, Suite 2w #201 Palm Springs, CA 92262-5750 United States Phone: (760) 323-9309 | Fax: (760) 610-8995 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CA | 00A978690 | — |
| MEDICAID | CA | GR0042690 | — |
| Other (non-Medicare) | CA | ZZZ50078Y | BLUE SHIELD |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207V00000X – Obstetrics & Gynecology | CA | A97869 |
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About NPI 1063619013
Lisa Monique Bodon M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1063619013. The primary specialty listed is Obstetrics & Gynecology. The provider is located in Palm Springs, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-07-02. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1063619013?
NPI 1063619013 belongs to Lisa Monique Bodon M.D., a Obstetrics & Gynecology in Palm Springs, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1063619013 active?
The current status of NPI 1063619013 in the NPPES registry is Active. The record was last updated on 2012-11-20.
What specialty is NPI 1063619013?
NPI 1063619013 is classified under the taxonomy Obstetrics & Gynecology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1063619013?
You can verify NPI 1063619013 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1063619013?
The primary practice address on file for NPI 1063619013 is 555 E Tachevah Dr, Palm Springs, CA 92262-5750. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1063619013 issued?
NPI 1063619013 was first issued (enumerated) on 2007-07-02. The NPPES record was last updated on 2012-11-20.
Practice Location Map
Lisa Monique Bodon is located at 555 E Tachevah Dr, Palm Springs, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Lisa Monique Bodon. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1063619013. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Obstetrics & Gynecology | A97869 | CA |