Individual provider · Type 1 NPI
Lisa Bodzio, PA-C
Surgical Physician Assistant · Fontana, CA
NPI number
1356548069
Active
Practice location
9985 Sierra Ave
Fontana, CA 92335-6720
Mailing address
9985 Sierra Ave Bldg 3, General Surgery Dept., 3rd Floor
Fontana, CA 92335-6720
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | PA 18410 (CA) |
Surgical Physician Assistant: Definition to come...
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About NPI 1356548069
Lisa Bodzio, PA-C's National Provider Identifier is 1356548069, issued on Jun 27, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Fontana, CA. The record was last updated on Nov 29, 2021.