MEDICARE: NAVNEET K. BODDU, M. D. A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207L00000X	Anesthesiology Physician
2	207LP2900X	Pain Medicine (Anesthesiology) Physician
3	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1548851280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVNEET K. BODDU, M. D. A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	638 CAMINO DE LOS MARES STE H130-517
Second Line	:
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-2848
Country	:	US
Telephone Number	:	760-429-7172
Fax Number	:	760-429-7161

Provider Business Practice Location Address
First Line	:	2125 S EL CAMINO REAL STE 200
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6260
Country	:	US
Telephone Number	:	760-429-7172
Fax Number	:	760-429-7161

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NAVNEET K. BODDU
Credential	:	MD
Telephone Number	:	760-429-7172

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	04/13/2026

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Directions to “NAVNEET K. BODDU, M. D. A PROFESSIONAL CORPORATION ” Practice Location

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