Susan K Bodtke, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

G88460 Issued in CA

Practice address

4311 3Rd Ave
San Diego, CA 92103-1407

Phone

(619) 688-1600

Fax

(619) 688-3099

NPI assigned

Jun 3, 2009

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1871729962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031407",
            "telephone_number": "619-688-1600",
            "fax_number": "619-688-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031407",
            "telephone_number": "619-688-1600",
            "fax_number": "619-688-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODTKE",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "G88460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauri Ann Bodie, POSTPARTUM DOULA
• Amisha Vishal Bodiwala, RT,(R)(M)
• Rona Bodman, D.D.S.
• Marta Ivanna Bodnaruk, NURSE PRACTITIONER
• Richard Michael Bodor, M.D.
• Body Craft, Inc.
• Body-Mind Acuity, Inc.
• Bodylife Works, Inc.
• Bodzin Chiropractic Professional Corporation
• Miles Ivan Bodzin, D.C.

• Adult Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.