Albert Bodt, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A41416 Issued in CA

Practice address

43112 15TH St W
Lancaster, CA 93534-6219

Phone

(661) 726-2306

Fax

(661) 726-2203

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1457439960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346219",
            "telephone_number": "661-726-2306",
            "fax_number": "661-726-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346219",
            "telephone_number": "661-726-2306",
            "fax_number": "661-726-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODT",
        "first_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A41416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE #",
            "identifier": "A41416",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPI/PPIN NUMBER",
            "identifier": "WA41416A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roshel Monique Blaylock Sanchez, AMFT, APCC
• Jaime Allison Andrea Blaylock
• Blessed Industries Outreach Lancaster LLC
• Blossom Care for the Elderly LLC
• Blue Shield Promise Healthplan (Blue Shield Promise Primary and Urgent Care Lancaster)
• Jennifer Boehmke, MFT INTERN
• Brianne Bogdanski
• Gerard H Boghossian, D.P.M.
• Patricia Bogna
• Travis Austin Boisvert

• Specialist in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.

Verify at the official NPI Registry.