Individual
LISA BODZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9985 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5000
Mailing address
9985 SIERRA AVE BLDG 3, GENERAL SURGERY DEPT., 3RD FLOOR, FONTANA, CA 92335-6720
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 18410
CA
Other
Enumeration date
06/27/2007
Last updated
11/29/2021
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