Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | G79183 | CA |
NPI | 1063454486 |
---|---|
Provider Name | Kimberly K Bedell |
First Address | Long Beach, CA 90853-1176 |
Second Address | Long Beach, CA 90806-1737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 08/07/2007 |