Organization
BONSAI HEALTH
Active
Organization
BONSAI HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUCHARITA BODDU MD (OWNER)
(973) 563-6064
Entity
Organization
Contact information
Practice address
16766 BERNARDO CENTER DR STE 206, SAN DIEGO, CA 92128-2502
(858) 381-0686
(858) 365-5189
Mailing address
16766 BERNARDO CENTER DR, SAN DIEGO, CA 92128-2545
(858) 381-0686
(858) 365-5189
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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