Provider Demographics
NPI:1376702696
Name:BIDERMANN, KRISTIN L (CPNP)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:L
Last Name:BIDERMANN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3860 CALLE FORTUNADA
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4800
Mailing Address - Country:US
Mailing Address - Phone:858-636-4300
Mailing Address - Fax:858-636-4319
Practice Address - Street 1:3030 CHILDRENS WAY
Practice Address - Street 2:SUITE #112
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4232
Practice Address - Country:US
Practice Address - Phone:858-495-0500
Practice Address - Fax:858-560-4279
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17698208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics