Active NPI
David F Bode, M.D.
- Body Imaging Physician
- West Covina, CA
National Provider Identifier
1306895990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- C30670
- Practice address
- 1135 S Sunset Ave
Ste 100
West Covina, CA 91790-3937 - Phone
- (626) 856-2215
- Fax
- (626) 960-2125
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | C30670 | CA | Primary |
Addresses
Primary practice location
1135 S Sunset Ave
Ste 100
West Covina, CA 91790-3937
Mailing address
777 Flower St Ste a
Glendale, CA 91201-3000
Phone (818) 637-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHL109627 | Other | CA | X-RAY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C30670 | CA | MD | Body Imaging Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Medical Associates, a Medical Group, Inc. | Body Imaging | Past | Accepting new patients |
Interoperability endpoints
- david.bode.p1@direct.lakeside.nextgenshare.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Lakeside Community Healthcare Medical Group
- Hospitalist Physician
- Glendale, CA
- NPI 1932129434
Body Imaging
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190937600000",
"number": "1306895990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 FLOWER ST STE A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912013000",
"telephone_number": "818-637-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 S SUNSET AVE",
"address_2": "STE 100",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903937",
"telephone_number": "626-856-2215",
"fax_number": "626-960-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODE",
"first_name": "DAVID",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2007-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "CA",
"license": "C30670",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "X-RAY",
"identifier": "RHL109627",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.