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General NPI Number Information
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NPI Number | 1164961934
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Entity Type | Organization
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Legal Business Name | MATTHEW BEDELL MD INC.
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 950 NORTHGATE DR STE 209
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3433
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Country | US
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Telephone | 415-461-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 950 NORTHGATE DR STE 209
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3433
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MATTHEW BEDELL
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Credential |
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Telephone | 858-342-2781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A124311
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License Number State | CA
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