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Individual
SHELLI S BODNAR
Active
Individual
SHELLI S BODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A60986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A60986
STATE LIC
CA
Enumeration date
10/04/2006
Last updated
10/20/2014
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