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NPI Code Detail

MEDICARE: DR. BRUCE J BIEDERMAN MD

MEDICARE: DR. BRUCE J BIEDERMAN 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
12085R0202XDiagnostic Radiology Physician25MA07983200NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790780997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE J BIEDERMAN MD
Provider Business Mailing Address
First Line : 8745 AERO DR
Second Line : SUITE 200
City : SAN DIEGO
State : CA
Zip : 92123-1761
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4002 VISTA WAY
Second Line :
City : OCEANSIDE
State : CA
Zip : 92056-4506
Country : US
Telephone Number : 760-940-4055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 03/23/2023

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