Richard Michael Bodor, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A053083 Issued in CA

Practice address

3350 La Jolla Village Dr
Section of VA Plastic Surgery, Mail Code 112K
San Diego, CA 92161-0001

Phone

(858) 642-3808

Fax

(858) 552-7530

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1386725463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "SECTION OF VA PLASTIC SURGERY, MAIL CODE 112K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610001",
            "telephone_number": "858-642-3808",
            "fax_number": "858-552-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "SECTION OF VA PLASTIC SURGERY, MAIL CODE 112K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610001",
            "telephone_number": "858-642-3808",
            "fax_number": "858-552-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODOR",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A053083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim L Bodie, LCSW
• Lauri Ann Bodie, POSTPARTUM DOULA
• Amisha Vishal Bodiwala, RT,(R)(M)
• Rona Bodman, D.D.S.
• Marta Ivanna Bodnaruk, NURSE PRACTITIONER
• Susan K Bodtke, M.D.
• Body Craft, Inc.
• Body-Mind Acuity, Inc.
• Bodylife Works, Inc.
• Bodzin Chiropractic Professional Corporation

• Plastic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.