Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | A105779 | CA |
NPI | 1316190085 |
---|---|
Provider Name | S. Samuel Bederman |
First Address | Orange, CA 92868-4246 |
Second Address | Orange, CA 92868-4246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 20/04/2021 |