NPIMap

Organization Active NPI

Palm Springs OB/GYN

  • Specialist
  • Palm Springs, CA
National Provider Identifier
1992946719
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A97869 Issued in CA
Legal business name
PALM SPRINGS OB/GYN
Practice address
1100 N Palm Canyon Dr
Suite 107
Palm Springs, CA 92262-4414
Phone
(760) 322-3166
Fax
(760) 322-9309
NPI assigned
Mar 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Authorized official

Name
Ms. Lisa M Bodon, M.D.
Title
President/ Director
Phone
(760) 322-3166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A97869 CA Primary

Addresses

Primary practice location

1100 N Palm Canyon Dr
Suite 107
Palm Springs, CA 92262-4414

Mailing address

PO Box 1886
Palm Springs, CA 92263-1886
Phone (760) 322-3166

Other identifiers 1

IdentifierTypeStateIssuer
A97869OtherCAALL NUMBERS ARE CURRENTLY PENDING

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236556800000",
    "number": "1992946719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1886",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922631886",
            "telephone_number": "760-322-3166",
            "fax_number": "760-322-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR",
            "address_2": "SUITE 107",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624414",
            "telephone_number": "760-322-3166",
            "fax_number": "760-322-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM SPRINGS OB/GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A",
        "authorized_official_last_name": "BODON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/ DIRECTOR",
        "authorized_official_telephone_number": "760-322-3166",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A97869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL NUMBERS ARE CURRENTLY PENDING",
            "identifier": "A97869",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.