Provider Demographics
NPI:1316190085
Name:BEDERMAN, S. SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:S.
Middle Name:SAMUEL
Last Name:BEDERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1120 W. LA VETA AVENUE SUITE 300
Mailing Address - Street 2:SPINE AND SPORTS SPECIALTIES MEDICAL GROUP
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4246
Mailing Address - Country:US
Mailing Address - Phone:714-598-1745
Mailing Address - Fax:714-941-9539
Practice Address - Street 1:1120 W. LA VETA AVENUE SUITE 300
Practice Address - Street 2:SPINE AND SPORTS SPECIALTIES MEDICAL GROUP
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4246
Practice Address - Country:US
Practice Address - Phone:714-598-1745
Practice Address - Fax:714-941-9539
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2021-04-20
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Provider Licenses
StateLicense IDTaxonomies
CAA105779207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine