Healthcare Provider Details

I. General information

NPI: 1649732132
Provider Name (Legal Business Name): QUINN MILLER-BEDELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N SEPULVEDA BLVD STE 270
MANHATTAN BEACH CA
90266-5975
US

IV. Provider business mailing address

1000 N SEPULVEDA BLVD STE 270
MANHATTAN BEACH CA
90266-5975
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax:
Mailing address:
  • Phone: 424-587-1101
  • Fax: 415-358-7739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA180480
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: