Individual
NAVNEET K. BODDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3626 RUFFIN RD, SAN DIEGO, CA 92123-1810
(858) 565-9666
(858) 565-9441
Mailing address
3626 RUFFIN RD, SAN DIEGO, CA 92123-1810
(858) 565-9666
(858) 565-9441
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A54188
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
A54188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A541880
BLUE SHIELD ID #
CA
05
—
00A541880
—
CA
01
—
00A541880385
CALOPTIMA ID #
CA
01
—
050084493
RAILROAD MEDICARE ID #
CA
Enumeration date
07/20/2006
Last updated
05/15/2025
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