MEDICARE: ISABELL H. BEDDOW MD

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	207V00000X	Obstetrics & Gynecology Physician	A69848	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942374269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABELL H. BEDDOW MD

Provider Business Mailing Address
First Line	:	616 VIRGINIA AVE
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94402-3241
Country	:	US
Telephone Number	:	650-458-8929
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 VIRGINIA AVE
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94402-3241
Country	:	US
Telephone Number	:	650-458-8929
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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