MEDICARE: DR. JACQUELINE VALDEZ-BEDIKIAN PHARM D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	43435	CA

General Provider Information

NPI Number	:	1093447419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE VALDEZ-BEDIKIAN PHARM D.

Provider Business Mailing Address
First Line	:	1344 ROSSMOYNE AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91207-1853
Country	:	US
Telephone Number	:	818-425-2585
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 WESTERN AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2870
Country	:	US
Telephone Number	:	818-242-5887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2022
Last Update Date	:	06/24/2022

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