Kathryn Bedor
Individual provider Active NPI Contractor · San Diego, CA
NPI 1285379263 · NPPES record last updated May 3, 2022
Key facts
- NPI
- 1285379263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- L9694 (CA)
- Practice address
- 9750 Miramar Rd Ste 130
San Diego, CA 92126-4561 - Phone
- (206) 829-0218
- NPI assigned
- May 3, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L9694 | CA | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | L9694 | CA | Yes |
Addresses
Primary practice location
9750 Miramar Rd Ste 130
San Diego, CA 92126-4561
Mailing address
3632 1/2 Meade Ave
San Diego, CA 92116-3619
Phone (206) 829-0218
Other names
- Kathryn Bedor
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.