Provider Demographics
NPI:1477230274
Name:BEDARIAN, GEORGE (LVN)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:BEDARIAN
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 AZALEA ST
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-2241
Mailing Address - Country:US
Mailing Address - Phone:323-479-9464
Mailing Address - Fax:
Practice Address - Street 1:333 SKYWAY DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8552
Practice Address - Country:US
Practice Address - Phone:805-383-1155
Practice Address - Fax:805-383-1134
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252428164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse