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General NPI Number Information
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NPI Number | 1700764206
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Entity Type | Organization
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Legal Business Name | SS BEDERMAN MD INC A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 31862 COAST HWY STE 400
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6788
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Country | US
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Telephone | 415-300-7110
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Fax | 714-941-9539
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Provider Business Mailing Address
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Address Line | 2618 SAN MIGUEL DR STE 229
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5437
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Country | US
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Telephone | 415-300-7110
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Fax | 714-941-9539
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Authorized Official
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Title or Position | MD
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Name | S SAMUEL BEDERMAN
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Credential |
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Telephone | 415-300-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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