Individual
LILLIAN JEAN BODANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(630) 251-9296
Mailing address
2775 MESA VERDE DR E APT P115, COSTA MESA, CA 92626-5009
(630) 251-9296
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86003712
CA
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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