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1275788770

NPI Code Detail

MEDICARE: DR. ARTUR BODNAR MD

MEDICARE: DR. ARTUR BODNAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744R1102X	Research Study Specialist	60294677	WA
2	208D00000X	General Practice Physician	MD.60294677	WA
3	208D00000X	General Practice Physician	MD60294677	WA

General Provider Information

NPI Number	:	1275788770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTUR BODNAR MD

Provider Business Mailing Address
First Line	:	222 N SEPULVEDA BLVD STE 2175
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-5639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 VALLEY VIEW LN STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5071
Country	:	US
Telephone Number	:	972-715-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	10/16/2020

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Directions to “ DR. ARTUR BODNAR MD” Practice Location

Language	Start Address	Practice Location

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