Individual
DR. DAVID J BODKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 644-3030
(619) 644-3438
Mailing address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 644-3030
(619) 644-3083
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G62107
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G62107
CALIFORNIA STATE LICENSE
CA
Enumeration date
12/12/2006
Last updated
11/20/2015
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