Individual
DR. ALBERT BODT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
43112 15TH ST W, LANCASTER, CA 93534-6219
(661) 726-2306
(661) 726-2203
Mailing address
43112 15TH ST W, LANCASTER, CA 93534-6219
(661) 726-2306
(661) 726-2203
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A41416
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A41416
MEDICAL LICENCE #
CA
01
—
WA41416A
NPPI/PPIN NUMBER
—
Enumeration date
11/01/2006
Last updated
07/12/2007
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