Healthcare Provider Details

I. General information

NPI: 1104314426
Provider Name (Legal Business Name): RYAN SINGH BEDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2483
US

IV. Provider business mailing address

1176 BIRCH AVE
CLOVIS CA
93611-0306
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-6829
  • Fax:
Mailing address:
  • Phone: 559-304-4251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: