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General NPI Number Information
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NPI Number | 1962552703
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Entity Type | Individual
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Provider Name | SANDRA ELIZABETH BENDECK RYDELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 5300 IRON HORSE PKWY # 371
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City | DUBLIN
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State | CA
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Zip | 94568-2043
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Country | US
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Telephone | 646-621-0780
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 IRON HORSE PKWY # 371
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City | DUBLIN
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State | CA
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Zip | 94568-2043
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Country | US
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Telephone | 646-621-0780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 053096
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A80276
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License Number State | CA
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